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

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...

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Autores principales:	Andrew Patton, Cathal O’Donnell, Owen Keane, Kieran Henry, Donal Crowley, Adrian Collins, Eoghan Redmond, Nicky Glynn, Martin Dunne, Conor Deasy
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Community emergency medicine Non-conveyance Pre-hospital Ambulance Alternative pathways Low acuity Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/bd87108a07174f7da52ef83308a91494
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spelling	oai:doaj.org-article:bd87108a07174f7da52ef83308a914942021-11-21T12:14:37ZThe Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine10.1186/s12873-021-00536-x1471-227Xhttps://doaj.org/article/bd87108a07174f7da52ef83308a914942021-11-01T00:00:00Zhttps://doi.org/10.1186/s12873-021-00536-xhttps://doaj.org/toc/1471-227XAbstract 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.Andrew PattonCathal O’DonnellOwen KeaneKieran HenryDonal CrowleyAdrian CollinsEoghan RedmondNicky GlynnMartin DunneConor DeasyBMCarticleCommunity emergency medicineNon-conveyancePre-hospitalAmbulanceAlternative pathwaysLow acuitySpecial situations and conditionsRC952-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENBMC Emergency Medicine, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Community emergency medicine Non-conveyance Pre-hospital Ambulance Alternative pathways Low acuity Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Community emergency medicine Non-conveyance Pre-hospital Ambulance Alternative pathways Low acuity Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Andrew Patton Cathal O’Donnell Owen Keane Kieran Henry Donal Crowley Adrian Collins Eoghan Redmond Nicky Glynn Martin Dunne Conor Deasy The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
description	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.
format	article
author	Andrew Patton Cathal O’Donnell Owen Keane Kieran Henry Donal Crowley Adrian Collins Eoghan Redmond Nicky Glynn Martin Dunne Conor Deasy
author_facet	Andrew Patton Cathal O’Donnell Owen Keane Kieran Henry Donal Crowley Adrian Collins Eoghan Redmond Nicky Glynn Martin Dunne Conor Deasy
author_sort	Andrew Patton
title	The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
title_short	The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
title_full	The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
title_fullStr	The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
title_full_unstemmed	The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
title_sort	alternative pre-hospital pathway team: reducing conveyances to the emergency department through patient centered community emergency medicine
publisher	BMC
publishDate	2021
url	https://doaj.org/article/bd87108a07174f7da52ef83308a91494
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The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine

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