ArticleBMJ open2021
Interventions and strategies involving primary healthcare professionals to manage emergency department overcrowding: a scoping review.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system.BMC health services research · 2024Pooled it
- Impact of hospital restructuring on emergency department quality: a natural experiment.Internal and emergency medicine · 2026Article
- Evaluation of an innovative "Emergency Department Surge" program for the care and treatment of patients with low-acuity conditions.Healthcare (Amsterdam, Netherlands) · 2026Article
- Rural Emergency 360°: A mixed-methods analysis of barriers and priorities for equitable emergency care in Québec.PloS one · 2026Article
- Sociodemographic and Health Behaviour of Frequent, Avoidable Emergency Department Users in Ontario, Canada: A Population-based Descriptive Study.The western journal of emergency medicine · 2025Article
- Relieving the pediatric emergency department by referring low triaged patients using the Manchester Triage System.European journal of pediatrics · 2025Article
- A Mixed-Methods Analysis of Negative Patient Experiences in Emergency Department Care: Identifying Challenges and Evidence-Informed Strategies Across the Care Continuum.Journal of patient experience · 2025Article
- Scoping review of the effectiveness of 10 high-impact initiatives (HIIs) for recovering urgent and emergency care services.BMJ open quality · 2024Article
- Non-emergency department (ED) interventions to reduce ED utilization: a scoping review.BMC emergency medicine · 2024Article
- Nursing Home Residents' Use of Radiography in New Brunswick: A Case for Mobile Radiography?Healthcare policy = Politiques de sante · 2023Article
- Article
- Overcrowding in Emergency Department: Causes, Consequences, and Solutions-A Narrative Review.Healthcare (Basel, Switzerland) · 2022Review
- Development of the use of primary health care emergency departments after interventions aimed at decreasing overcrowding: a longitudinal follow-up study.BMC emergency medicine · 2022Observational
- Time-series cohort study to forecast emergency department visits in the city of Milan and predict high demand: a 2-day warning system.BMJ open · 2022Article
Corrections and comments
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Authors and funding
25 authors.
Funding
Abstract
objectivesTo conduct a scoping review to identify and summarise the existing literature on interventions involving primary healthcare professionals to manage emergency department (ED) overcrowding.
designA scoping review. DATA SOURCES: A comprehensive database search of Medline (Ovid), EMBASE (Ovid), Cochrane Library (Wiley) and CINAHL (EBSCO) databases was conducted (inception until January 2020) using peer-reviewed search strategies, complemented by a search of grey literature sources. ELIGIBILITY CRITERIA: Interventions and strategies involving primary healthcare professionals (PHCPs: general practitioners (GPs), nurse practitioners (NPs) or nurses with expanded role) to manage ED overcrowding.
methodsWe engaged and collaborated, with 13 patient partners during the design and conduct stages of this review. We conducted this review using the JBI guidelines. Two reviewers independently selected studies and extracted data. We conducted descriptive analysis of the included studies (frequencies and percentages).
resultsFrom 23 947 records identified, we included 268 studies published between 1981 and 2020. The majority (58%) of studies were conducted in North America and were predominantly cohort studies (42%). The reported interventions were either 'within ED' (48%) interventions (eg, PHCP-led ED triage or fast track) or 'outside ED' interventions (52%) (eg, after-hours GP clinic and GP cooperatives). PHCPs involved in the interventions were: GP (32%), NP (26%), nurses with expanded role (16%) and combinations of the PHCPs (42%). The 'within ED' and 'outside ED' interventions reported outcomes on patient flow and ED utilisation, respectively.
conclusionsWe identified many interventions involving PHCPs that predominantly reported a positive impact on ED utilisation/patient flow metrics. Future research needs to focus on conducting well-designed randomized controlled trials (RCTs) and systematic reviews to evaluate the effectiveness of specific interventions involving PHCPs to critically appraise and summarise evidence on this topic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.