International Emergency Nursing Vol. 62 May 2022
The effectiveness of primary care streaming in emergency departments on decision-making and patient flow and safety – A realist evaluation
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Title
International Emergency Nursing Vol. 62 May 2022
The effectiveness of primary care streaming in emergency departments on decision-making and patient flow and safety – A realist evaluation
The effectiveness of primary care streaming in emergency departments on decision-making and patient flow and safety – A realist evaluation
Subject
The effectiveness of primary care streaming in emergency departments
Description
Primary care streaming was implemented in UK Emergency Departments (EDs) to manage an increasing demand for urgent care. We aimed to explore its effectiveness in EDs with different primary care models and identify contexts and mechanisms that influenced outcomes: streaming patients to the most appropriate clinician or service, ED flow and patient safety.
Method: We observed streaming and interviewed ED and primary care staff during case study visits to 10 EDs in England. We used realist methodology, synthesising a middle-range theory with our qualitative data to refine and create a set of theories that explain relationships between contexts, mechanisms and outcomes.
Results: Mechanisms contributing to the effectiveness of primary care streaming were: quality of decision-making, patient flow, redeploying staff, managing patients across streams, the implementation of governance protocols, guidance, training, service evaluation and quality improvement efforts. Experienced nurses and good
teamworking and strategic and operational management were key contextual factors.
Conclusion: We recommend service improvement strategies, operational management, monitoring, evaluation and training to ensure that ED nurses stream patients presenting at an ED seeking urgent care to the most appropriate clinicians for their needs in a safe and efficient manner.
Method: We observed streaming and interviewed ED and primary care staff during case study visits to 10 EDs in England. We used realist methodology, synthesising a middle-range theory with our qualitative data to refine and create a set of theories that explain relationships between contexts, mechanisms and outcomes.
Results: Mechanisms contributing to the effectiveness of primary care streaming were: quality of decision-making, patient flow, redeploying staff, managing patients across streams, the implementation of governance protocols, guidance, training, service evaluation and quality improvement efforts. Experienced nurses and good
teamworking and strategic and operational management were key contextual factors.
Conclusion: We recommend service improvement strategies, operational management, monitoring, evaluation and training to ensure that ED nurses stream patients presenting at an ED seeking urgent care to the most appropriate clinicians for their needs in a safe and efficient manner.
Creator
Michelle Edwards, Alison Cooper, Thomas Hughes, Freya Davies, Delyth Price, Pippa Anderson, Bridie Evans, Andrew Carson-Stevens, Jeremy Dale , Peter Hibbert, Barbara Harrington, Julie Hepburn, Aloysius Niroshan Siriwardena, Helen Snooks, Adrian Edwards
Publisher
Elsevier Ltd.
Date
May 2022
Contributor
Sri Wahyuni
Rights
1755-599X
Format
PDF
Language
English
Type
Text
Coverage
International Emergency Nursing Vol. 62 May 2022
Files
Citation
Michelle Edwards, Alison Cooper, Thomas Hughes, Freya Davies, Delyth Price, Pippa Anderson, Bridie Evans, Andrew Carson-Stevens, Jeremy Dale , Peter Hibbert, Barbara Harrington, Julie Hepburn, Aloysius Niroshan Siriwardena, Helen Snooks, Adrian Edwards, “International Emergency Nursing Vol. 62 May 2022
The effectiveness of primary care streaming in emergency departments on decision-making and patient flow and safety – A realist evaluation,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/1732.
The effectiveness of primary care streaming in emergency departments on decision-making and patient flow and safety – A realist evaluation,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/1732.