Advertisement

Evaluation of an Ambulatory Emergency Care Centre at a tertiary hospital in Perth, Western Australia

Published:February 10, 2022DOI:https://doi.org/10.1016/j.auec.2022.02.001

      Abstract

      Background

      Emergency Departments around the world are under increasing pressure due to rising demand. In the United Kingdom ambulatory emergency care has been demonstrated to deliver safe and effective care for emergency patients and has now become an accepted treatment modality.

      Methods

      This paper outlines a quality improvement project undertaken to evaluate an ambulatory emergency care centre implemented at a tertiary hospital in Perth, Western Australia, from February to August 2021.

      Results

      The findings demonstrated a 4% improvement in the Western Australian Emergency Access Target for a four week period, a 6.3% reduction in the number of patients admitted with a length of stay less than 24 h and that patient’s attending the Ambulatory Emergency Care Centre were managed as safely as if they were seen in the Emergency Department.

      Abbreviations:

      AECC (Ambulatory Emergency Care Centre), ED (Emergency Department)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Australasian Emergency Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Irvine N, Megiddo I, van der Meer R. Ambulatory emergency care. Amsterdam, Netherlands; 2018.

      2. Pownall A. Perth hospital crisis: emergency departments fall behind four-hour benchmark. The West Australian; 2021.

      3. Ambulatory Emergency Care Network. Directory of Ambulatory Emergency Care for Adults [Internet]. NHS Elect; 2018. Available from: 〈https://www.ambulatoryemergencycare.org.uk/uploads/files/1/AEC-Directory%206th%20edition%20February%202018.pdf〉.

        • Cottrell E.
        • Mallen C.D.
        • Lasserson D.S.
        Ambulatory emergency care: how should acute generalists manage risk in undifferentiated illness?.
        Br J Gen Pract. 2018; 68: 12-13
      4. Galipeau J, Pussegoda K, Stevens A, Brehaut JC, Curran J, Forster AJ, et al. Effectiveness and safety of short-stay units in the emergency department: a systematic review. In: Zehtabchi S (editor). Acad emerg med., vol. 22(8); 2015, p. 893–907.

      5. Australasian College, for Emergency Medicine. Emergency Department Short Stay Units Guidelines [Internet]; 2019. Available from: 〈file:///C:/Users/Carolyn/Downloads/Guidelines_on_ED_Short_Stay_Units.pdf〉.

        • Reid L.E.M.
        • Dinesen L.C.
        • Jones M.C.
        • Morrison Z.J.
        • Weir C.J.
        • Lone N.I.
        The effectiveness and variation of acute medical units: a systematic review.
        Int J Qual Health Care. 2016; 28: 433-446
        • Osborne S.
        • Cleak H.
        • White N.
        • Lee X.
        • Deacon A.
        • de Looze J.W.M.
        Effectiveness of clinical criteria in directing patient flow from the emergency department to a medical assessment unit in Queensland, Australia: a retrospective chart review of hospital administrative data.
        BMC Health Serv Res. 2021; 21: 527
      6. Connolly VM, Thompson D. Acute care toolkit 10: ambulatory emergency care [Internet]. Royal College of Physicians; 2014. Available from: 〈file:///C:/Users/Carolyn/Downloads/Acute%20care%20toolkit%2010%20-%20Ambulatory%20emergency%20care_0%20(6).pdf〉.

        • Hamad M.M.A.A.
        • Connolly V.M.
        Ambulatory emergency care – improvement by design.
        Clin Med. 2018; 18: 69-74
      7. Urgent and Emergency Care Review Team, Emergency Care Intensive Support Team. Safer, faster, better: good practice in delivering urgent and emergency care. A Guide for local health and social care communities. [Internet]; 2015. Available from: 〈https://www.england.nhs.uk/wp-content/uploads/2015/06/trans-uec.pdf〉.

      8. Government of Western Australia. South metropolitan health service. South Metropolitan Health Service; 2018.

      9. Department of Health 2021. Emergency department – fiona stanley fremantle hospitals group healthpoint page [Internet]; 2021. Available from: 〈https://fsh-healthpoint.hdwa.health.wa.gov.au/directory/clinicalservices/ed/pages/default.aspx〉.

      10. Australian Institute of Health and Welfare. My hospitals [Internet]; 2021. Available from: 〈https://www.aihw.gov.au/reports-data/myhospitals〉.

      11. NHS Ambulatory Emergency Care Network [Internet]. NHS ambulatory emergency care network; 2016. Available from: 〈https://www.ambulatoryemergencycare.org.uk/〉.

        • Ala L.
        • Mack J.
        • Shaw G.
        • Gasson A.
        The AMB Score: a pilot study to develop a scoring system to identify which acute medicine referrals would be appropriate for ambulatory care management.
        Acute Med. 2010; 9: 141
        • Jarral W.
        • Graf B.
        • Harding S.
        • Roberts G.
        • Seymour J.
        Direct referrals from emergency department streaming to ambulatory care: improving same-day emergency care.
        Future Health J. 2020; 7 ([s39–s39])
      12. Health Policy Analysis. Australian emergency care classification definitions manual [Internet]. Independent Hospital Pricing Authority; 2019. Available from: 〈https://www.ihpa.gov.au/sites/default/files/aecc_definitions_manual_version_4.pdf〉.

        • Weihser P.
        • Giles D.
        Establishing an ambulatory care service using point-of-care testing diagnostics.
        Br J Hosp Med. 2018; 79: 520-523
        • Narayan N.
        • Gulliford S.R.
        Can ambulatory emergency care have a positive impact on acute services?.
        Acute Med. 2015; 14: 125-131
      13. The Department of Health Western Australia. Non-admitted activity reference manual [Internet]; 2019. Available from: 〈https://ww2.health.wa.gov.au/~/media/Files/Corporate/Policy-Frameworks/Information-management/Policy/Non-Admitted-Activity-Recording-and-Reporting/Supporting/Non-Admitted-Activity-Reference-Manual.pdf〉.

        • Byrne G.
        • Richardson M.
        • Brunsdon J.
        • Patel A.
        An evaluation of the care of patients with minor injuries in emergency settings.
        Accid Emerg Nurs. 2000; 8: 101-109
        • Heaney D.
        • Paxton F.
        Evaluation of a nurse-led minor injuries unit.
        Nurs Stand. 1997; 12: 35-38
        • Baier N.
        • Geissler A.
        • Bech M.
        • Bernstein D.
        • Cowling T.E.
        • Jackson T.
        • et al.
        Emergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands – analyzing organization, payment and reforms.
        Health Policy. 2019; 123: 1-10
        • Wang B.
        • Mehrotra A.
        • Friedman A.B.
        Urgent care centers deter some emergency department visits but, on net, increase spending: study examines whether growth of retail urgent care centers deterred lower-acuity emergency department visits.
        Health Aff. 2021; 40: 587-595
        • Pacheco J.
        • Cuadrado C.
        • Martínez-Gutiérrez M.S.
        Urgent care centres reduce emergency department and primary care same-day visits: a natural experiment.
        Health Policy Plan. 2019; 34: 170-177