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How do emergency departments respond to ambulance pre-alert calls? A qualitative exploration of the management of pre-alerts in UK emergency departments.
Long, Jaqui; Sampson, Fiona C; Coster, Joanne; O'Hara, Rachel; Bell, Fiona; Goodacre, Steve.
Afiliación
  • Long J; SCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
  • Sampson FC; SCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK f.c.sampson@sheffield.ac.uk.
  • Coster J; SCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
  • O'Hara R; SCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
  • Bell F; Yorkshire Ambulance Service NHS Trust, Wakefield, UK.
  • Goodacre S; SCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
Emerg Med J ; 2024 Sep 17.
Article en En | MEDLINE | ID: mdl-39288976
ABSTRACT

BACKGROUND:

Calls to emergency departments (EDs) from ambulances to alert them to a critical case being transported to that facility that requires a special response ('pre-alerts') have been shown to improve outcomes for patients requiring immediate time-critical treatment (eg, stroke). However, little is known about their usefulness for other patients and the processes involved in ED responses to them. This study aimed to understand how pre-alerts influence patient care in the ED.

METHODS:

We undertook non-participant observation (162 hours, 143 pre-alerts) and semi-structured interviews with staff (n=40) in six UK EDs between August 2022 and April 2023 focusing on how ED staff respond to pre-alert calls and what influences their response. Observation notes and interview transcripts were imported into NVivo and analysed using a thematic approach.

RESULTS:

Pre-alert calls involved significant time and resources for ED staff but they were valued as they enabled staff to prepare for a patient's arrival (practically and psychologically). High demand and handover delays at ED created additional pre-alerts due to ambulance clinician concerns about the impact of long waits on patients.Despite the risk of pre-alert fatigue from calls for patients considered not to require a special response, ED clinicians appreciated timely pre-alert information, perceiving a higher risk from underalerting than overalerting. Variation in ED response was influenced by individual and organisational factors, particularly the resources available at the time of pre-alert. Unclear ED processes for receiving, documenting and sharing information about pre-alerts increased the risk of information loss.

CONCLUSION:

Improving processes for receiving and sharing pre-alert information may help ED clinicians prepare appropriately for incoming patients. Alternative routes for ambulance clinicians to seek advice on borderline pre-alert patients may help to improve the appropriateness of pre-alerts.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Emerg Med J Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Emerg Med J Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido