Evidence map›Paper›PMID 39288976›Full record

ArticleEmergency medicine journal : EMJ2024

How do emergency departments respond to ambulance pre-alert calls? A qualitative exploration of the management of pre-alerts in UK emergency departments.

Jaqui Long, Fiona C Sampson, Joanne Coster, Rachel O'Hara, Fiona Bell, Steve Goodacre

Abstract read
In one paragraph

Article in Emergency medicine journal : EMJ, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

6 authors.

Jaqui LongSCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
Fiona C SampsonSCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK f.c.sampson@sheffield.ac.uk.ORCID http://orcid.org/0000-0003-2321-0302
Joanne CosterSCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.ORCID http://orcid.org/0000-0002-0599-4222
Rachel O'HaraSCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
Fiona BellYorkshire Ambulance Service NHS Trust, Wakefield, UK.ORCID http://orcid.org/0000-0003-4503-1903
Steve GoodacreSCHARR, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.ORCID http://orcid.org/0000-0003-0803-8444

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCalls to emergency departments (EDs) from ambulances to alert them to a critical case being transported to that facility that requires a special response ('pre-alerts') have been shown to improve outcomes for patients requiring immediate time-critical treatment (eg, stroke). However, little is known about their usefulness for other patients and the processes involved in ED responses to them. This study aimed to understand how pre-alerts influence patient care in the ED.

methodsWe undertook non-participant observation (162 hours, 143 pre-alerts) and semi-structured interviews with staff (n=40) in six UK EDs between August 2022 and April 2023 focusing on how ED staff respond to pre-alert calls and what influences their response. Observation notes and interview transcripts were imported into NVivo and analysed using a thematic approach.

resultsPre-alert calls involved significant time and resources for ED staff but they were valued as they enabled staff to prepare for a patient's arrival (practically and psychologically). High demand and handover delays at ED created additional pre-alerts due to ambulance clinician concerns about the impact of long waits on patients.Despite the risk of pre-alert fatigue from calls for patients considered not to require a special response, ED clinicians appreciated timely pre-alert information, perceiving a higher risk from underalerting than overalerting. Variation in ED response was influenced by individual and organisational factors, particularly the resources available at the time of pre-alert. Unclear ED processes for receiving, documenting and sharing information about pre-alerts increased the risk of information loss.

conclusionImproving processes for receiving and sharing pre-alert information may help ED clinicians prepare appropriately for incoming patients. Alternative routes for ambulance clinicians to seek advice on borderline pre-alert patients may help to improve the appropriateness of pre-alerts.

Indexed as

emergency departmentshealth service accessibilitypre-hospitalqualitative research

Identifiers

PMID39288976
PMCPMC11874362

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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.