Urgent care centre in Sweden—the integration of teams and perceived effects

Abstract

Summary An urgent care centre (UCC) is an upcoming trend in Swedish health care. Although UCCs have been established in other countries, their effectiveness and value have not yet been studied in Sweden. The aim of this study was to investigate the interaction between the UCC and emergency department (ED) by using validated evaluation models. One adult ED (AED) and one child ED (CED), together with a newly established UCC nearby, were included in this study. The interaction between the UCC team and the ED teams was studied by using two evaluation models: one for evaluation of integration and the other one for the evaluation of the effects, in terms of perceived relief of the ED after the establishment of the UCC. It was evident that integration was achieved early on in the course of the follow‐up. However, the perception of integration varied between low (EDs) and high collaboration (UCC). All respondents of the EDs indicated relief, in terms of pace and pressure on the ED since the UCC was established. This study indicates that the grade of integration and collaboration between UCC and ED can be achieved automatically and very early during the establishment. It also shows that UCCs can be a competent complement to EDs and alleviate some of the heavy pressure placed on EDs due to ED overcrowding.

Strength in the gap: A rapid review of principles and practices for urgent care centres

“… 12 , 13 Swedish ED personnel, after the formation of a nearby UCC, did report subjective capacity pressure reduction. 14 A Chilean study also reported a minor (2.7%) reduction in ED visits after UCC establishment. 15 A study of six American states demonstrated a 17.2% reduction in ED visits during times when UCCs in the corresponding zip code were open.…”

Facilidades e entraves da referência em unidade de pronto atendimento

“…Um estudo sueco, que investigou a interação entre um Centro Atendimento de Urgência (UCC) e emergências hospitalares adulto e pediátrica, identificou como desafio: fazer com que os profissionais de ambos os serviços se conhecessem, o que diminuiria as controvérsias e aumentaria a confiança entre as equipes. Explicase que os UCC são serviços de saúde, tipicamente compostos por médicos, enfermeiros e auxiliares de Enfermagem, que funcionam no nível intermediário de cuidados à saúde, entre as emergências hospitalares e a atenção primária 15 , similares às UPA brasileiras.…”

“…Na Suécia, um estudo revelou que, mesmo que houvesse uma diretriz baseada no diagnóstico e na gravidade, regulando a distribuição dos pacientes entre os Departamentos de Emergência hospitalares e o UCC, ainda haveria certa ambiguidade sobre como interpretá-la, julgando-se necessário recrutar pessoal com longa experiência em triagem para evitar erros 15 .…”

Outcomes of Establishing an Urgent Care Centre in the Same Location as an Emergency Department

“…Questions about the parties' capacity for diagnosing and treating patients were sorted out, and non-conventional solutions were occasionally invented to handle strenuous situations and tricky cases. Mistakes in assessments and patients whose health conditions rapidly changed could easily be handled by swift re-referrals from the UCC back to the ED [17].…”

“…Doran showed that patients treated by UCCs, sited together with and in close collaboration with an ED, received swift service and better follow-up than the control group in the study [16]. UCCs and EDs have also proven to be horizontally integrated and collaborative and function informally between ED and UCC staff [17].…”