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A classification of primary care streaming pathways in UK emergency departments: findings from a multi-methods study comprising cross-sectional survey; site visits with observations, semi-structured and informal interviews

Edwards, Michelle ORCID: https://orcid.org/0000-0001-7432-2828, Cooper, Alison ORCID: https://orcid.org/0000-0001-8660-6721, Hughes, Thomas, Davies, Freya ORCID: https://orcid.org/0000-0002-6956-1100, Sherlock, Rebecca, Anderson, Pippa, Evans, Bridie, Carson-Stevens, Andrew ORCID: https://orcid.org/0000-0002-7580-7699, Cookes, Matthew, Dales, Jeremy, Hibbert, Peter, Harrington, Barbara, Hepburn, Julie, Porter, Alison, Rainer, Timothy ORCID: https://orcid.org/0000-0003-3355-3237, Siriwardena, Aloysius Niroshan, Snooks, Helen and Edwards, Adrian ORCID: https://orcid.org/0000-0001-7432-2828 2021. A classification of primary care streaming pathways in UK emergency departments: findings from a multi-methods study comprising cross-sectional survey; site visits with observations, semi-structured and informal interviews. International Emergency Nursing 56 , 101000. 10.1016/j.ienj.2021.101000

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Abstract

Background Variation in initial assessment methods at emergency departments in with primary care service models and a conflated terminology causes difficulties in assessing relative performance, improving quality or gathering evidence about safety and clinical effectiveness. We aim to describe and classify streaming pathways in emergency departments in different models of emergency department primary care services in England and Wales. Methods We used a multi-stage method, including an online survey completed by 77 emergency departments across England & Wales, interviews with 21 clinical leads, and in-depth case studies of 13 emergency departments. All qualitative data were triangulated and analysed using a framework approach. Results Common emergency department pathways to primary care services were: front door streaming; streaming inside the emergency department; or primary care staff selecting patients. Pathways were also in place to redirect patients with non-urgent primary care problems to community primary care services. Streaming and redirection pathways were often adapted, with variation in protocols based on local circumstances. Conclusion Clinical leads should consider which pathway(s) best suit their local context. Consistency of terminology used to describe pathways between emergency departments and primary care services is necessary for performance measurement, quality improvement and rigorous future multi-site evaluative and descriptive research.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Additional Information: email 15/3/21 - Hi,Please can you remove Timothy Rainer and Sirwardena Niroshan from the Cardiff Author list.Many thanks,Deborah
Publisher: Elsevier
ISSN: 1755-599X
Date of First Compliant Deposit: 12 March 2021
Date of Acceptance: 8 March 2021
Last Modified: 11 Nov 2022 04:28
URI: https://orca.cardiff.ac.uk/id/eprint/139647

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