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Open Access 01-12-2021 | Emergency Medicine | Research

The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine

Authors: Andrew Patton, Cathal O’Donnell, Owen Keane, Kieran Henry, Donal Crowley, Adrian Collins, Eoghan Redmond, Nicky Glynn, Martin Dunne, Conor Deasy

Published in: BMC Emergency Medicine | Issue 1/2021

Abstract

Background

Internationally increasing demand for emergency care is driving innovation within emergency services. The Alternative Pre-Hospital Pathway (APP) Team is one such Community Emergency Medicine (CEM) initiative developed in Cork, Ireland to target low acuity emergency calls.

In this paper the inception of the APP Team is described, and an observational descriptive analysis of the APP Team’s service data presented for the first 12 months of operation. The aim of this study is to describe and analyse the APP team service.

Methods

The APP Team, consisting of a Specialist Registrar (SpR) in Emergency Medicine (EM) and an Emergency Medical Technician (EMT) based in Cork, covers a mixed urban and rural population of approximately 300,000 people located within a 40-min drive time of Cork University Hospital. The team are dispatched to low acuity 112/999 calls, aiming to provide definitive care or referring patients to the appropriate community or specialist service.

A retrospective analysis was performed of the team’s first 12 months of operation using the prospectively maintained service database.

Results

Two thousand and one patients were attended to with a 67.8% non-conveyance rate. The median age was 62 years, with 33.0% of patients aged over 75 years. For patients over 75 years, the non-conveyance rate was 62.0%. The average number of patients treated per shift was 7. Medical complaints (319), falls (194), drug and alcohol related presentations (193), urological (131), and respiratory complaints (119) were the most common presentations.

Conclusion

Increased demand for emergency care and an aging population is necessitating a re-design of traditional models of emergency care delivery. We describe the Alternative Pre-Hospital Pathway service, delivered by an EMT and an Emergency Medicine SpR responding to low acuity calls. This service achieved a 68% non-conveyance rate; our data demonstrates that a community emergency medicine outreach team in collaboration with the National Ambulance Service offering Alternative Pre-Hospital Pathways is an effective model for reducing conveyances to hospital.

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Title: The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
Authors: Andrew Patton
Cathal O’Donnell
Owen Keane
Kieran Henry
Donal Crowley
Adrian Collins
Eoghan Redmond
Nicky Glynn
Martin Dunne
Conor Deasy
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Emergency Medicine
Care
Published in: BMC Emergency Medicine / Issue 1/2021
Electronic ISSN: 1471-227X
DOI: https://doi.org/10.1186/s12873-021-00536-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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