Improving communication in the emergency department

Source: Emergency Medicine Journal, 26 (9), 658-661

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Year of publication: September 2009

Publication type: Journal Article

In a nutshell: A previous study examined the communication process within the emergency department (ED) and identified a complex process with many opportunities for breakdown and error. In this paper the first two interventions in a series of studies to improve this highly vulnerable communication process are described.  Observational study and audit revealed the extent of process failures identified in the initial FMEA process. With the introduction of simple changes to the communication system, a marked improvement in the availability and quality of pertinent clinical information was achieved with considerable implications for the timeliness and quality of care provided to patient

Length of publication: 4 pages

Some important notes: Please contact your local NHS Library for the full text of the article.  Follow this link to find your local NHS Library

GP and A&E survey

Source: Primary Care Foundation

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Year of publication: August 2009

Publication type: Website

In a nutshell: The Primary Care Foundation is carrying out a study of the use of primary care clinicians within or alongside Emergency Departments (A&E). The aim is to understand the range of different models and report on the various elements that need to be in place for such initiatives to operate safely and successfully. To achieve this they are asking all Emergency Departments, commissioners and the primary care provider organisations in England to complete a questionnaire.

Length of publication: 1 web page, with links to survey

Some important notes: Follow the links from the web page to view the Survey Instructions; Summary of Project; Best Practice; and Reference Group

New stroke and major trauma centres to improve care for Londoners

Source: Healthcare for London

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Year of publication: July 2009

Publication type: Report

In a nutshell: Following a consultation to improve stroke and trauma services, a committee of PCTs decided to introduce four major trauma centres, eight hyper-acute stroke units and better local services across London, with the new facilities expected to open by summer 2011.
The centres will operate 24 hours a day, seven days a week and will be staffed by consultant-led specialist teams with access to the best facilities. These centres will be linked to local units delivering high quality general and rehabilitation care. The new services are expected to save around 500 lives a year and reduce long-term disability for thousands.

Length of publication: 1 web page

Some important notes: Follow this link to view the news release

Greater Manchester Urgent Care Clinical Congress 2009

Source: Commissioning Business Service

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Year of Publication: July 2009

Publication type:  Website

In a nutshell: The Greater Manchester (GM) Urgent Care Clinical Congress took place on 10th July, 2009 and was designed to build a shared understanding of the case for change to optimise the delivery of urgent care services for local people.  The event, run by the Association of GM PCTs and the GM Urgent Care Network, had valuable support and input from the Commissioning Business Service (CBS).  Speakers included Mike Farrar, senior A&E doctors and experienced GPs.  The congress engaged a wide range of clinical, managerial and patient stakeholders to establish the current situation across GM and the priorities for action on urgent care across all services.  The GM Urgent Care Network will work to implement congress recommendations.

Length of publication: Webpage with link to pdf output report

Out-of-hours care in western countries: assessment of different organizational models

Source: BMC Health Services Research 2009, 9:105

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Date of publication: June 2009

Publication type: Journal article

In a nutshell: Internationally, different organizational models are used for providing out-of-hours care. This study used a survey across 25 countries to assess prevailing models and identify their potential strengths and weaknesses.   In most countries several different models existed alongside each other, including Accident & Emergency, rota groups and GP cooperatives.  The perceived strengths and weaknesses of these models are discussed.  GP cooperatives combine size of scale advantages with high accessibility, continuity and coordination of care. While specific patients require other organizational models, the co-existence of different models for out-of-hours care in a country may be less efficient for health systems.

Length of publication: 21 pages

Ten things your emergency department should consider to prepare for pandemic influenza

Source: Emergency Medicine Journal 2009; 26:497-500

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Date of publication: July 2009

Publication type: Journal article

In a nutshell: Pandemic influenza remains a potential major threat to global public health. It is essential for emergency departments to be involved in planning for the management of such a major event. It is also important for emergency departments to be clear on their internal arrangements for staff and for patient care. This paper outlines 10 suggestions for UK emergency departments based on the recent experience of emergency departments in Hong Kong and elsewhere.

Length of publication: 4 pages

Some important notes: An NHS Athens password is required to access the full text of this article.  Please contact your local NHS library for further details – follow this link to find your local NHS Library

Emergency services review

Source: Department of Health

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Date of publication: June 2009

Publication type: Report

In a nutshell:  This review aims to provide support to local health communities to improve the effectiveness of emergency care and achieve national standards during times of high demand.  The review responds to dips in performance during the Winter of 2008/2009 and has three components: 1) Learning lessons: data analysis and developing practical advice for operational leaders to respond to increased demand – due Summer 2009; 2) Repackaging quality guidelines, toolkits and how-to guides into a coherent offering – due September 2009; 3) Practical support from a team of emergency care specialists to local health communities and organisations – starts June 2009

Length of publication: 2 Pages

A systematic review of models for forecasting the number of emergency department visits

Source: Emergency Medicine Journal  

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Date of publication: June 2009 

Publication type: Systematic review

In a nutshell: The ability to predict patient visits to emergency departments is crucial for designing strategies aimed at avoiding overcrowding.  Knowledge of the mathematical models used to predict patient volume is essential. Articles were reviewed for studies designed to predict patient attendance at ED or walk-in clinics. The mathematical methods developed to predict ED visits have a low rate of error, but the prediction of daily patient visits should be used carefully and therefore does not allow day-to-day adjustments of staff.  ED managers should be aware of the model limitations. These models should be used to assess future needs.

Length of publication: 5 pages

Some important notes: An NHS Athens password is required to access the full text of this article.  Please contact your local NHS library for further details

In an emergency – call the Clinical Librarian!

Source: Emergency Medicine Journal, 2009, 26 (5) p. 321-323

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Date of publication: May 2009

Publication type: Journal article

In a nutshell: This paper reviews the role of the clinical librarian in the emergency department

Length of publication: 3 pages 

Some important notes: An NHS Athens password is required to access the full text of this article. Please contact your local NHS library for further details

A Reengineered Hospital Discharge Program to Decrease Rehospitalization

Source: Annals of Internal Medicine, 2009, 150 (3) p. 178-187

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Date of publication: February 2009

Publication type: Journal article 

In a nutshell: Emergency department visits and rehospitalization are common after hospital discharge. This study tested the effects of an intervention designed to minimize hospital utilization after discharge. A nurse discharge advocate worked with patients during their hospital stay to arrange follow-up appointments, confirm medication reconciliation, and conduct patient education with an individualized instruction booklet that was sent to their primary care provider.  A clinical pharmacist called patients 2 to 4 days after discharge to reinforce the discharge plan and review medications.

Length of publication: 11 pages

Some important notes:  To access the full text of this article please contact your local NHS library.  Research funded by Agency for Healthcare Research and Quality and National Heart, Lung, and Blood Institute, National Institutes of Health.

Acknowledgement: National Health and Medical Research Council (Australia) Emergency Care Communities of Practice Blog