Article Text

other Versions

PDF
Reducing inappropriate emergency department attendances—a review of ambulance service attendances at a regional teaching hospital in Scotland
  1. Gareth Gordon Patton,
  2. Shobhan Thakore
  1. Correspondence to Dr Gareth Patton, Emergency Department, Ninewells Hospital, Dundee DD1 9SY, UK; garethpatton{at}nhs.net

Abstract

Introduction Emergency Departments (ED) in the UK have seen increasing attendance rates in recent years. Departments are now seeking strategies to reduce their attendances. A review of all ambulance attendances to the ED at Ninewells Hospital was conducted to identify if patients presenting by ambulance could be seen and treated more appropriately in other parts of the health service.

Method A retrospective review of ambulance attendances to the ED at Ninewells Hospital over 7 non-consecutive days. The ambulance patient report form and the ED notes were reviewed by the duty consultant to deem whether it was appropriate for the patient to be presented to the ED. If inappropriate, an alternative destination was suggested. Additional data was collected on the source of the ambulance call.

Results There were 910 attendances in the 7 days. 295 (32%) presented by ambulance. 32 had incomplete data and were excluded. 185 (70%) and 179 (68%) of the 263 were deemed appropriate from review of the patient report form and notes respectively. Of the inappropriate, 74.4% and 79.7% had primary care suggested as an alternative. Patients who call for their own ambulance and NHS24 had higher rates of inappropriate attendances.

Discussion The ambulance services present one-third of the patients to the ED at Ninewells Hospital. 30%–32% were found to be attending inappropriately and 74%–80% of these could have been managed in primary care. Reducing inappropriate ambulance attendances could reduce the departmental patient load by 11%.

  • Paediatric emergency med
  • resuscitation
  • emergency department
  • chest
  • abdomen
  • analgesia pain control
  • education

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data collected and used is based and held in the Emergency Department, Ninewells Hospital. All data collected was used and included in the article.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.