Contributing Factors of Frequent Use of the Emergency Department

Overcrowding of the emergency department is a growing problem. Frequent users contribute to the overcrowding problem in emergency departments | International Emergency Nursing

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Introduction: Overcrowding in emergency departments is an issue that has a negative impact worldwide. As attendance in emergency departments has increased, the ability to provide critical services to patients suffering from actual medical emergencies in a timely manner has decreased as these departments are many times at or over capacity. One patient population whose negative influence has been researched with regard to their impact on the overcrowding issue is that of the frequent user.

Results: A review of the literature identified two predominant factors related to frequent users in the emergency department: a lack of awareness of medical necessity and issues of access.

Discussion: To address the frequent users in emergency departments, implications for practice need to be explored and implemented. Implications for practice include education of medical necessity for the frequent users, expansion of the pre-hospital role in primary care and inappropriate use prevention, and improvement of access to alternative healthcare services.

Full reference: Burns, T.R. (2017) Contributing Factors of Frequent Use of the Emergency Department: A Synthesis. International Emergency Nursing. Published online: 5 June 2017

Only a third of MPs believe that A&E departments are adequately resourced 

Parliamentary perceptions of A&E departments |  A poll of UK MPs by Dods Research on behalf of the Royal College of Emergency Medicine

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A poll on behalf of  the Royal College of Emergency Medicine reveals just 33% of MPs believe emergency departments have the resources they need to keep patients safe.

The poll of 92 MPs of all parties and regions of the UK also found strong support for a transformation fund for emergency departments with four times as many saying they would support such an initiative as oppose it.

Over 60% of MPs said they would support Emergency Departments (EDs) receiving more money to help with the retention and recruitment of staff.

Despite government claims that the NHS was getting more than the minimum £8bn by 2020 it had asked for, the poll found that only half of Conservative MPs believe that Emergency Departments are currently being adequately resourced.

View the full report here

NHS ambulance services

The National Audit Office (NAO) has published NHS ambulance services.

This report provides an update to the NAO 2011 report and examines:

  • the challenges facing the ambulance service in England
  • the performance of the service
  • the extent to which the service is maximising its impact and supporting the challenges facing the wider health system.

It highlights that NHS ambulance services are finding it increasingly difficult to cope with rising demand for urgent and emergency services.

Full report: NHS Ambulance Services

NAO Podcast on Ambulance Service:

 

Additional links: BBC news report

ICT system to compensate for a sudden shortage of emergency department physicians

Tanaka, K. et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. Published online: 23 January 2017

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Background: A sudden shortage of physician resources due to overwhelming patient needs can affect the quality of care in the emergency department (ED). Developing effective response strategies remains a challenging research area. We created a novel system using information and communication technology (ICT) to respond to a sudden shortage, and tested the system to determine whether it would compensate for a shortage.

 

Discussion: After introducing the system, probability of multiple casualties increased. Thus the system may contribute to improvement in the ability to respond to sudden excessive patient needs in multiple causalities.

Conclusions: A novel system using ICT successfully secured immediate responses from needed physicians outside the hospital without increasing user workload, and increased the ability to respond to excessive patient needs. The system appears to be able to compensate for a shortage of physician in the ED due to excessive patient transfers, particularly during off-hours.

Read the full article here

A & E performance: The view of NHS Providers

Following recent media coverage of NHS accident and emergency department performance, NHS Providers has published NHS Providers view on NHS A&E performance and linked media coverage

This briefing sets out facts about current A&E performance without underplaying the real pressures facing providers.

The briefing hihghlights the following:

  • Very few trusts are performing well, as measured by meeting the seeing 95% of A&E patients within the four-hour standard. We expect overall NHS performance for last week against the standard to be between 70 and 80%.
  • The vast majority of trusts are coping with the demand, in terms of avoiding persistently long trolley and 12-hour waits but some are struggling to do so.
  • There is a small number of trusts who are failing to cope with the demand and who have seen persistently large trolley and 12-hour waits. These tend to have lasted for short periods as corrective management action kicks in. Clearly, any incident of unavoidable harm is unacceptable and trusts are doing all they can to avoid them.

Read the full briefing here