Roderick Little Prize Session

001 A PROSPECTIVE STUDY OF GP REFERRALS TO THE ACCIDENT AND EMERGENCY DEPARTMENT: OPTIMISING PATIENT CARE PATHWAYS

F. Ya’Ish, H. M. Sherriff.

Objective: Increased pressure on accident and emergency (A&E) departments has necessitated the implementation of strategies to streamline patient care pathways and speed up the process of assessment and treatment. This study reviews direct general practitioner (GP) referrals to A&E, and aims to assess these patient episodes, establish suitability of referral, and suggest methods to improve these management pathways in the future.

Methods: This is a prospective study of direct GP referrals to a medium sized A&E department over a 3 month period. These referrals were identified on attendance to the A&E department. A review of these cases was carried out at the end of the 3 month period.

Results: The study identified 252 patients for further review. This represents 2.4% of the total A&E attendances during the study period. Twelve cases were excluded from the final analysis. The remaining patients (240) were categorised as follows: 27% were cases that could be managed in primary care, 16% required further referral to the related specialty, and only 14% required direct A&E input and discharge. Of the 43% of cases referred for x ray, 70% had no abnormal findings.

Conclusion: 175 patients were identified as not requiring direct A&E input, representing 72.9% of the total studied referrals. The authors discuss and analyse methods to improve the suitability of referral patterns from GPs. Implementation of these methods may help to improve patient care and decrease the burden on A&E departments.

002 THE TIMI RISK SCORE ACCURATELY RISK STRATIFIES PATIENTS WITH UNDIFFERENTIATED CHEST PAIN PRESENTING TO AN EMERGENCY DEPARTMENT

A. C. Morris, D. Caesar, S. Gray, A. Gray.

Introduction: The thrombolysis in myocardial infarction (TIMI) risk score predicts the risk of significant cardiac events in patients admitted to specialist cardiac units. Several abstracts published from the USA suggest similar results when …