Primary care services located with EDs: a review of effectiveness

Ramlakhan, Shammi; Mason, Suzanne; O’Keeffe, Colin; Ramtahal, Alicia; Ablard, Suzanne

doi:10.1136/emermed-2015-204900

Cited by 57 publications

(65 citation statements)

References 36 publications

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“…The latter is supported by other studies, the evidence for improved throughput when co-locating GPCs at EDs is poor. [15,17] As said, the number of patients assessed and treated at the ED decreased with 20%. At the same time, the caseload at the ED changed significantly.…”

Section: Discussionmentioning

confidence: 95%

“…Although marginal savings per patient may be realized, this is likely to be overshadowed by the overall cost of introducing a new service. [15] In some other studies, the introduction of a co-located GPC with an ED has failed to reduce attendances. [15,16] Our study contradicts these fi ndings: 20% of our patients were referred to the GPC.…”

Section: Discussionmentioning

confidence: 99%

“…[15] In some other studies, the introduction of a co-located GPC with an ED has failed to reduce attendances. [15,16] Our study contradicts these fi ndings: 20% of our patients were referred to the GPC. Unfortunately, there were no signs of an improved throughput for the remaining patients at the ED.…”

Section: Discussionmentioning

confidence: 99%

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Effects of a general practitioner cooperative co-located with an emergency department on patient throughput

Veelen

Brand

Reijnen

et al. 2016

World Journal of Emergency Medicine

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BACKGROUND:In 2013 a General Practitioner Cooperative (GPC) was introduced at the Emergency Department (ED) of our hospital. One of the aims of this co-located GPC was to improve throughput of the remaining patients at the ED. To determine the change in patient fl ow, we assessed the number of self-referrals, redirection of self-referrals to the GPC and back to the ED, as well as ward and ICU admission rates and length of stay of the remaining ED population. METHODS:We conducted a four months' pre-post comparison before and after the implementation of a co-located GPC with an urban ED in the Netherlands. RESULTS:More than half of our ED patients were self-referrals. At triage, 54.5% of these selfreferrals were redirected to the GPC. After assessment at the GPC, 8.5% of them were referred back to the ED. The number of patients treated at the ED declined with 20

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Effects of a general practitioner cooperative co-located with an emergency department on patient throughput

Veelen

Brand

Reijnen

et al. 2016

World Journal of Emergency Medicine

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“…The large proportion of patients in this study who unsuccessfully attempted contact with a PCP before coming to the ED indicates that strategies to reduce barriers to PCP access in Alberta, Canada, have had minimal impact and may be compounded by an undersupply of family physicians 21. Similar strategies are being attempted globally (eg, expanded hours, urgent care clinics, patient attachment, co-location of walk-in clinics with EDs,19 20 etc). Given the results of this study and the wide array of patient rationales for ED presentation, these strategies may need to be enhanced to address the complexities of patient decisions to visit the ED.…”

Section: Discussionmentioning

confidence: 99%

Low-acuity presentations to the emergency department in Canada: exploring the alternative attempts to avoid presentation

et al. 2016

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“…In this landmark paper, Ramlakhan et al 11 set out to review and analyse the success of these co-located services reported from seven countries.…”

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confidence: 99%