Patient experience of non-conveyance following emergency ambulance service response: A scoping review of the literature

King, Robbie; Oprescu, Florin; Lord, Bill; Flanagan, Belinda

doi:10.1016/j.auec.2020.08.006

Cited by 25 publications

(37 citation statements)

References 33 publications

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“…The results from this study with high scores concerning listening and understanding the patients’ description of the perceived illness are consistent with previous studies on patients’ experiences of the AS and when subjected to non-conveyance [ 13 ]. Patients point out the basic human need to be taken seriously, which can be achieved by listening when they describe their illness experience, i.e., spending time with the patient [ 15 ].…”

Section: Discussionsupporting

confidence: 91%

“…The phenomenon of non-conveyance has been explored through epidemiological measures [ 4 – 8 ], indicating that between 12 and 42% of all ambulance assignments resulted in non-conveyance to the Accident and Emergency department (A&E). On the other hand, studies describing the phenomenon from Specialist Ambulance Nurses’ (SAN) perspective [ 9 – 12 ] reveal patient safety issues and lack of clarity in the guidelines Furthermore, knowledge concerning the satisfaction patients and significant others when subjected to non-conveyance is relatively scare and mostly limited to qualitative studies [ 13 – 18 ]. The AS have been facing a growing demand due to changes in population demographics and an increasing number of calls and ambulance assignments [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…How patients experience care is a measure of its quality, which possibly has an impact on patient safety [ 32 ]. The source of dissatisfaction in the AS setting is often linked to poor communication, lack of a professional attitude, inadequate medical assessments, insufficient information and needs not being met by clinicians [ 13 , 33 , 34 ]. Patients express that they want to have their needs fulfilled, despite being aware that their condition is non-urgent and not life-threatening.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the AS is often patients’ first contact with the health care system. Studies indicate that patients experience the care provided as positive [ 13 , 37 ] and even expressed satisfaction [ 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

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Satisfaction among non-conveyed patients and significant others when discharged at the scene by the ambulance service: an exploratory cross-sectional survey

et al. 2022

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Background The ambulance service is facing an increased number of calls and ambulance assignments. Between 12 and 42% of all assignments result in non-conveyance to the Accident and Emergency Department. However, there is limited knowledge regarding satisfaction among patients and significant others when patients are assessed as non-urgent and discharged at the scene. Therefore, the aim of the study was to explore and compare satisfaction with the ambulance service among patients and significant others when the patient was discharged at the scene. Methods The present study was designed as a cross-sectional exploratory survey with a consecutive sample employing the Consumer Emergency Care Satisfaction Scale questionnaire on patients and significant others. Results A total of 162 questionnaires were analysed, 87 patients and 75 significant others. Overall, satisfaction was high with no significant difference between patients and significant others, although 17-19% were dissatisfied with the discharge information. Conclusions Generally, patients and significant others are satisfied with the care provided by the Ambulance Service when discharged at the scene and thus not conveyed the Accident and Emergency Department. The participants were especially satisfied with Specialist Ambulance Nurses’ interpersonal skills, e.g., making time and providing thorough information. Guidelines for assignments involving non-conveyance, as well as information, instructions and what to expect when discharged at the scene can be improved.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Satisfaction among non-conveyed patients and significant others when discharged at the scene by the ambulance service: an exploratory cross-sectional survey

et al. 2022

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“…Our study's crude and adjusted logistic models demonstrated that EMS missions for patients in small cities and rural areas were associated with lower odds of ending missions by NC due to PIR compared to EMS missions in Riyadh city. Therefore, besides previous studies, our study indicates that a phenomenon of NC due to PIR needs to be addressed by conducting further research involving the public and patients [33].…”

Section: Discussionmentioning

confidence: 78%

Non-Conveyance Due to Patient-Initiated Refusal in Emergency Medical Services: A Retrospective Population-Based Registry Analysis Study in Riyadh Province, Saudi Arabia

Moafa

Kuijk

Moukhyer

et al. 2021

IJERPH

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This research study aimed to investigate the association between demographic and operational factors and emergency medical services (EMS) missions ending in non-conveyance (NC) due to patient-initiated refusal (PIR). We conducted a retrospective population-based registry study by analyzing 67,620 EMS missions dispatched to the scene during 2018 in the Riyadh province. First, the number and percentages of conveyances statuses were calculated. Then, using crude and adjusted linear and logistic regression analysis, we determined which characteristics were predictors of NC due to PIR. We found that 23,991 (34.4%) of missions ended in NC due to PIR, and 5969 ended in EMS-initiated refusal (8.6%). NC rates due to PIR were higher for women, adults, for missions in Riyadh city, during nighttime, for medical emergencies, and for advanced life support (ALS) crews. We also found the following additional predictors significantly associated with the odds of NC due to PIR in crude regression analyses: age category, geographical location, EMS-shift, time of call, emergency type, and response time. We conclude that the NC rate represents half of all missions for patients requesting EMS, and the rate in Riyadh city has increased compared to previous studies. Most NC cases occur for the highest urgency level of medical emergency type in Riyadh city during the nighttime with ALS crews. NC due to PIR involves younger patients more than elderly, and females more than males. This study’s findings have provided empirical evidence that indicate that conducting further studies involving EMS providers, patients, and the public to identify precise and detailed reasons is required.

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Treat and release: an observational study of non-conveyed high-acuity dispatches in a Danish emergency medical system

Wolthers,

Mikaelsson,

Holgersen

et al. 2024

Intern Emerg Med

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Non-conveyance refers to the practice of treating a patient on-site without transporting them to a medical facility. It may decrease unnecessary hospital transfers and improve patient satisfaction. Nonetheless, ensuring patient safety remains paramount. The objective of the study was to assess admission to hospital and mortality in non-conveyed patients. This population-based cohort study included all high-acuity dispatches in Region Zealand, Denmark between 2019 and 2022. The primary outcome was admission within 48 h, and the secondary outcome was 30-day mortality. Descriptive statistical analyses were conducted, and logistic regression models were used to estimate adjusted odds ratios and 95% confidence intervals. A non-conveyance rate of 14% was identified in 95,238 transports. Admission within 48 h was seen in 22% of non-conveyed patients vs. 95% in conveyed patients, p < 0.001. The adjusted analysis showed a decreased likelihood of admission within 48 h within non-conveyed patients, with an aOR of 0.01 95% CI (0.01–0.01). Non-conveyed patients had a crude 30-day mortality rate of 2 vs. 6% among conveyed patients, p < 0.001. The adjusted analysis showed an increased likelihood of 30-day mortality in non-conveyed patients with an odds ratio of 1.21, 95% CI (1.05–1.40). Non-conveyed patients constitute a substantial proportion of patients assessed by ambulances following high-acuity dispatch. Less than one in four non-conveyed patients were admitted within 48 h. Despite the low crude mortality in this study, an increased likelihood of mortality was found within the non-conveyed population. However, additional investigation is warranted in future research.

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Patient experience of non-conveyance following emergency ambulance service response: A scoping review of the literature

Cited by 25 publications

References 33 publications

Satisfaction among non-conveyed patients and significant others when discharged at the scene by the ambulance service: an exploratory cross-sectional survey

Satisfaction among non-conveyed patients and significant others when discharged at the scene by the ambulance service: an exploratory cross-sectional survey

Non-Conveyance Due to Patient-Initiated Refusal in Emergency Medical Services: A Retrospective Population-Based Registry Analysis Study in Riyadh Province, Saudi Arabia

Treat and release: an observational study of non-conveyed high-acuity dispatches in a Danish emergency medical system

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