Safety of telephone consultation for "non-serious" emergency ambulance service patients

Dale, Jim

doi:10.1136/qhc.13.5.363

Cited by 28 publications

(39 citation statements)

References 13 publications

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“…For example, adverse events have been examined by asking patients directly, through retrospective examination of health records, and through panel assessments of whether decisions were safe. 13,16,25 This variance was also identified in a recent focus group study of US EMS services, in which safety was assessed in multiple ways, including by retrospective chart reviews and follow-up phone calls with patients. 4 Just as this review was useful for identifying outcomes that are used frequently, it is also valuable to shed light on under-reported outcome categories.…”

Section: Discussionmentioning

confidence: 87%

“…[8][9][10][11] Seven articles were used for this purpose. [12][13][14][15][16][17][18] The database search was conducted in PubMed, EMBASE, CINAHL and the Cochrane Library in 2012 and repeated on May 19, 2014. The search was created using a combination of Medical Subject Headings (MeSH) and keywords in PubMed, and mapped to the other databases using their designated thesauri.…”

Section: Data Sourcementioning

confidence: 99%

“…25 Articles were from the UK (n = 6), the United States (n = 6), Canada (n = 2), and Iran (n = 1). Eleven of these EMS systems were paramedicbased, 12,13,15,16,18,[21][22][23][24][25][26] two were physician-based with basic emergency medical technicians, 3,27 and in one report the type of EMS system was unclear. 28 The following interventions were studied: transferring 911 callers to nurse-advice lines (n = 6), EMS dispatch providing advice or self-care instructions (n = 4), alternative EMS response being dispatched (n = 3), and identification of low acuity calls that do not require EMS response (n = 2).…”

Section: Outcome Measures Reported On Alternatives To Ems Dispatchmentioning

confidence: 99%

“…• Decision on medical necessity (if patient required ED care), triage decision 1,14,18,44,54,62,63 • Clinician decision may be compared to expert panel or physicians, 1,3,13,27,50 or if patient seen in ED or admitted to hospital 12,18,44 .…”

Section: ;17(5)mentioning

confidence: 99%

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Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

Jensen

Carter

Rose

et al. 2015

CJEM

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Objectives: Emergency medical services (EMS) programs, which provide an alternative to traditional EMS dispatch or transport to the emergency department (ED), are becoming widely implemented. This scoping review identified and catalogued all outcomes used to measure such alternative EMS programs. Data Source: Broad systematized bibliographic and grey literature searches were conducted. Study Selection: Inclusion criteria were 911 callers/EMS patients, reported on alternatives to traditional EMS dispatch OR traditional EMS transport to the ED, and reported an outcome measure. Data Extraction: The reports were categorized as either alternative to dispatch or to EMS transport, and outcome measures were categorized and described. Data Synthesis: The bibliographic search retrieved 13,215 records, of which 34 articles met the inclusion criteria, with an additional 10 added from reference list hand-searching (n = 44 included). In the grey literature search, 31 websites were identified, from which four met criteria and were retrieved (n = 4 included). Fifteen reports (16 studies) described alternatives to EMS dispatch, and 33 reports described alternatives to EMS transport. The most common outcomes reported in the alternatives to EMS dispatch reports were service utilization and decision accuracy. Twenty-four different specific outcomes were reported. The most common outcomes reported in the alternatives to EMS transport reports were service utilization and safety, and 50 different specific outcomes were reported. Conclusions: Numerous outcome measures were identified in reports of alternative EMS programs, which were catalogued and described. Researchers and program leaders should achieve consensus on uniform outcome measures, to allow benchmarking and improve comparison across programs. RÉSUMÉObjectif: Les programmes de services médicaux d'urgence (SMU), qui offrent une solution de rechange à la répartition traditionnelle des SMU ou au transport classique des malades aux services des urgences (SU), gagnent de plus en plus de terrain. Dans l'examen d'établissement de la portée décrit ici, les auteurs ont relevé et classé tous les résultats utilisés pour mesurer l'efficacité de ces programmes novateurs de SMU. Sources des données: Les auteurs ont entrepris une vaste recherche systématisée de références bibliographiques, et effectué des recherches méthodiques dans la documentation parallèle. Sélection des études: Les critères de sélection comprenaient les appels faits aux services d'urgence 911 ou les malades examinés par les SMU, inscrits dans les rapports de solutions de rechange à la répartition traditionnelle des SMU OU au transport classique des malades au SU par les SMU, ainsi que l'existence d'un critère d'évaluation. Extraction des données: Les rapports ont été classés soit dans la catégorie des solutions de rechange à la répartition des services, soit dans la catégorie des solutions de rechange aux transports effectués par les SMU; quant aux critères d'évaluation, ils ont été classés et décrits. Synthèse...

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Section: Discussionmentioning

confidence: 87%

Section: Data Sourcementioning

confidence: 99%

Section: Outcome Measures Reported On Alternatives To Ems Dispatchmentioning

confidence: 99%

Section: ;17(5)mentioning

confidence: 99%

See 2 more Smart Citations

Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

Jensen

Carter

Rose

et al. 2015

CJEM

View full text Add to dashboard Cite

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“…The feasibility of expanding the current service to include diversion of ambulance calls should be explored, as studies have shown that diverting emergency calls to a call-in nurse service may potentially reduce the number of ED attendances without increased adverse outcomes. (34)(35)(36) Similarly, follow-up calls to subgroups of patients identified as having high reattendance rates, such as the young population in the present study, may help address parental concerns and alleviate the burden of ED reattendance. However, current studies have not demonstrated a reduction in reattendance rates in the paediatric ED (37,38) and the practicality of such a strategy remains questionable.…”

Section: Discussionmentioning

confidence: 99%

Unplanned reattendances at the paediatric emergency department within 72 hours: a one-year experience in KKH

Goh¹,

Huang²,

Kong³

et al. 2015

smedj

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De kwaliteit van telefonische triage op huisartsenposten

Derkx¹,

Maiburg²,

Winkens³

et al. 2009

HUWE

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SamenvattingDerkx HP, Rethans JJ, Maiburg BH, Winkens RAG, Muijtjens AM, Van Rooij HG, Knottnerus JA. De kwaliteit van telefonische triage op huisartsenposten. Huisarts Wet 2009;52(7):326-32. Doel Om de kwaliteit en veiligheid van telefonische triage op een huisartsenpost te bepalen moeten we de kwaliteit van de verschillende fasen van dit zorgproces onderzoeken. Dit betekent dat we niet alleen moeten beoordelen of de triagist het juiste urgentieniveau heeft bepaald, maar ook dat we de kwaliteit van de medisch inhoudelijke vragen en de inhoud van een zelfzorgen vangnetadvies moeten onderzoeken. Methode Voor de uitvoering van dit onderzoek belden twaalf telefonische simulatiepatiënten (TSP's) in de periode april 2006 tot juli 2007 naar zeventien verschillende huisartsenposten voor zeven medische problemen. De TSP's belden iedere huisartsenpost voor iedere casus driemaal. Resultaten De triagisten stelden gemiddeld 21% van de verplichte vragen die in de standaarden waren vermeld. Gemiddeld 54% van alle gestelde vragen behoorde tot de categorie verplichte vragen. Niet altijd schatten de triagisten het belang van een antwoord op een vraag op de juiste wijze in. Triagisten bepaalden voor 58% van alle gesprekken de gewenste urgentie. Voor 41% was het urgentieniveau te laag en voor 1% te hoog ingeschat. De kwaliteit van de zelfzorg-en vangnetadviezen varieerde sterk per casus en was op alle huisartsenposten beperkt. Conclusie De triagisten formuleerden meestal een zorgadvies na het stellen van een zeer beperkt aantal verplichte vragen, waardoor ze een mogelijk gezondheidsrisico voor de patiënt niet tot het minimum beperkten. Als we de kwaliteit tijdens opeenvolgende fasen van het zorgproces van telefonische triageonderzoeken, kunnen we vaststellen in hoeverre triagisten de juiste urgentie bepalen op basis van voldoende en juist geïnter-preteerde informatie of dat het toeval daarbij een grote rol heeft gespeeld. Om de veiligheid van telefonische triage te bevorderen moeten triagisten niet alleen de juiste vragen stellen en de antwoorden correct inschatten, maar ook een volledig zelfzorgen vangnetadvies geven. Universiteit Maastricht, Afdeling huisartsgeneeskunde, Postbus 616, 6200 MD Maastricht: dr. H.P. Derkx, arts, onderzoeker; dr. J.J. Rethans, arts, universitair hoofddocent; dr. H.J.S. Maiburg, huisarts, adjunct-hoofd huisartsopleiding; dr. R.A.G. Winkens, huisarts en hoofdonderzoeker; dr.ir. A.M.M. Muijtjens, statisticus-methodoloog, universitair hoofddocent; drs. H.G. van Rooij, arts, kwaliteitsmanager Huisartsenpost Tilburg; prof.dr. J.A. Knottnerus, hoogleraar huisartsgeneeskunde. Correspondentie: hay.derkx@medicinfo.nl Belangenverstrengeling: niets aangegeven. Dit artikel is een bewerkte vertaling van: Derkx HP, Rethans JJ, Maiburg BH, Winkens RAG, Muijtjens AM, Van Rooij HG, Knottnerus JA. Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study. BMJ 2008;337;a1264. Publicatie gebeurt met toestemming van de uitgever.

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Safety of telephone consultation for "non-serious" emergency ambulance service patients

Cited by 28 publications

References 13 publications

Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

Unplanned reattendances at the paediatric emergency department within 72 hours: a one-year experience in KKH

De kwaliteit van telefonische triage op huisartsenposten

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