Evidence map›Paper›PMID 34794391›Full record

Observational studyBMC emergency medicine2021

The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine.

Andrew Patton, Cathal O'Donnell, Owen Keane, Kieran Henry, Donal Crowley, Adrian Collins, Eoghan Redmond, Nicky Glynn, Martin Dunne, Conor Deasy

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 15 citations in OpenAlex.

  1. "I just needed help": a qualitative study of patients' experiences with a single responder ambulance.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Andrew PattonEmergency Department, Cork University Hospital, Wilton, Cork, Ireland. andrew@pattons.ie.
Cathal O'DonnellMedical Directorate, National Ambulance Service, Health Service Executive, Limerick, Ireland.
Owen KeaneEmergency Department, Cork University Hospital, Wilton, Cork, Ireland.
Kieran HenryNational Ambulance Service, Health Service Executive, Cork, Ireland.
Donal CrowleyNational Ambulance Service, Health Service Executive, Cork, Ireland.
Adrian CollinsNational Ambulance Service, Health Service Executive, Cork, Ireland.
Eoghan RedmondSchool of Medicine, University College Cork, Cork, Ireland.
Nicky GlynnNational Ambulance Service, Health Service Executive, Cork, Ireland.
Martin DunneNational Ambulance Service, Health Service Executive, Cork, Ireland.
Conor DeasyEmergency Department, Cork University Hospital, Wilton, Cork, Ireland.
Health Service Executive · IECork University Hospital · IEUniversity College Cork · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInternationally increasing demand for emergency care is driving innovation within emergency services. The Alternative Pre-Hospital Pathway (APP) Team is one such Community Emergency Medicine (CEM) initiative developed in Cork, Ireland to target low acuity emergency calls. In this paper the inception of the APP Team is described, and an observational descriptive analysis of the APP Team's service data presented for the first 12 months of operation. The aim of this study is to describe and analyse the APP team service.

methodsThe APP Team, consisting of a Specialist Registrar (SpR) in Emergency Medicine (EM) and an Emergency Medical Technician (EMT) based in Cork, covers a mixed urban and rural population of approximately 300,000 people located within a 40-min drive time of Cork University Hospital. The team are dispatched to low acuity 112/999 calls, aiming to provide definitive care or referring patients to the appropriate community or specialist service. A retrospective analysis was performed of the team's first 12 months of operation using the prospectively maintained service database.

resultsTwo thousand and one patients were attended to with a 67.8% non-conveyance rate. The median age was 62 years, with 33.0% of patients aged over 75 years. For patients over 75 years, the non-conveyance rate was 62.0%. The average number of patients treated per shift was 7. Medical complaints (319), falls (194), drug and alcohol related presentations (193), urological (131), and respiratory complaints (119) were the most common presentations.

conclusionIncreased demand for emergency care and an aging population is necessitating a re-design of traditional models of emergency care delivery. We describe the Alternative Pre-Hospital Pathway service, delivered by an EMT and an Emergency Medicine SpR responding to low acuity calls. This service achieved a 68% non-conveyance rate; our data demonstrates that a community emergency medicine outreach team in collaboration with the National Ambulance Service offering Alternative Pre-Hospital Pathways is an effective model for reducing conveyances to hospital.

Indexed as

Emergency Medical ServicesEmergency MedicineAgedEmergency Service, HospitalHospitalsHumansMiddle AgedPatient-Centered CareRetrospective StudiesAlternative pathwaysAmbulanceCommunity emergency medicineLow acuityNon-conveyanceParamedicinePre-hospital

Identifiers

PMID34794391
PMCPMC8601091
OpenAlexW3212771719

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.