The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
Dublin Core
Title
The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine
Subject
Community emergency medicine, Non-conveyance, Pre-hospital, Ambulance, Alternative pathways, Low
acuity, Paramedicine
acuity, Paramedicine
Description
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% nonconveyance 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.
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% nonconveyance 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.
Creator
Andrew Patton, Cathal O’Donnell, Owen Keane, Kieran Henry, Donal Crowley, Adrian Collins, Eoghan Redmond, Nicky Glynn, Martin Dunne and Conor Deasy
Publisher
BMC Emergency Medicine
Date
(2021) 21:138
Contributor
Fajar Bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Andrew Patton, Cathal O’Donnell, Owen Keane, Kieran Henry, Donal Crowley, Adrian Collins, Eoghan Redmond, Nicky Glynn, Martin Dunne and Conor Deasy , “The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine,” Repository Horizon University Indonesia, accessed September 20, 2024, https://repository.horizon.ac.id/items/show/3919.