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EMERGENCIES BY APPOINTMENT: WOULD PATIENTS WITH MINOR INJURIES PREFER A BOOKED APPOINTMENT AT THEIR LOCAL EMERGENCY DEPARTMENT TO THE CURRENT WALK-IN SERVICE PROVISION
  1. Lynn Roberts,
  2. Linda Dykes
  1. Emergency Department, Ysbyty Gwynedd, Bangor, Gwynedd, United Kingdom

    Abstract

    Objectives & Background Emergency Departments (ED) typically offer walk-in services for minor injuries, and patients arriving at peak times may experience delays. Other NHS services (e.g. GP, dentists and GUM) utilise booked appointments even for urgent problems.

    We wished to ascertain whether patients attending our ED (a DGH with a very large rural catchment area) with minor injuries would find an appointment system accessed via phone/internet acceptable, and also their views on perhaps being asked to return for an appointment later the same (or following) day, should they arrive when waiting times are unacceptably long.

    Methods A cross-sectional sample of 512 ED attendees with minor injuries/conditions were identified by the triage nurse. A questionnaire with a semi-structured design was used to determine the experiences, opinions and preferences of patients with minor injuries/conditions in relation to the proposed development of an appointment system. Ethical approval was obtained. Statistical analysis used mainly non-parametric tests plus descriptive statistics, with cluster analysis used to predict associations with patients' willingness to accept booked appointment.

    Results Overall, most participants (79%) indicated they were strongly supportive of the concept of booked appointments as an alternative to the current “walk-in” system, particularly those who would book by internet/phone (p=0.000).

    Younger patients, those in employment, and those with lower levels of anxiety and perceived urgency were also significantly more likely to find booked appointments acceptable.

    Being asked to return for a later appointment having already arrived at the ED was deemed less popular, although patients living closer to the hospital were more likely to find being asked to return for an appointment acceptable (p=0.012).

    Conclusion This study confirms acceptance of the concept of ED offering appointments to minor injury patients. Participants would prefer pre-booked appointments over being asked to return later or next day, but they would accept either in preference to enduring excessive delays.

    • emergency care systems

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