What is the aim of the study?
This study will look at what happens when people need urgent medical care and may need to stay in hospital. Researchers will use computer models to explore whether changing how patients reach different hospital services could help them get the right care sooner and reduce delays. They will look at options such as referring patients straight to specialist teams and making more use of Same Day Emergency Care. This is a service where patients can be assessed and treated without staying in hospital overnight.
Why is this research needed?
Emergency departments and services that care for people with urgent medical problems across the UK are under growing pressure. More patients need care, many have complex health problems, and delays across the healthcare system can mean people wait longer for assessment and treatment.
People who need an emergency medical admission usually see a team that treats a wide range of urgent medical conditions. Some patients may benefit from seeing a specialist team sooner. For example, some hospitals have separate services for people living with frailty, breathing problems or heart conditions.
A change that helps one group of patients could cause delays or put pressure on other services. This study will explore these possible effects before major changes are made.
What will the researchers do?
Researchers will study information already collected in electronic patient records as part of routine care. They will look at each stage of a patient’s hospital care, from arriving at the emergency department to assessment, tests, treatment decisions and leaving hospital. This will include whether patients need to stay in hospital.
The study will look at:
- How long patients spend at each stage of their care.
- Delays while waiting for test results or a hospital bed.
- How busy emergency departments and a shortage of available beds affect care.
- Whether some patients could safely see a specialist team sooner.
- Whether more patients could receive Same Day Emergency Care.
Researchers will use this information to build computer models of how hospital services work together. They will use the models to explore possible changes and estimate how these might affect patients, waiting times and the use of staff, beds and other resources. The models will help researchers understand what might happen; they will not show for certain what the results of a change would be.
How have patients and the public been involved?
Patients have said that long waits, moving between different assessment areas, poor communication and delays in getting results are among the most frustrating parts of emergency care. Feedback from patient experience systems, complaints, compliments and conversations with patients has helped shape this study.
Patient representatives have strongly supported using information from health records to improve how people receive care when they need an emergency admission. The research team plans to keep patients involved throughout the study. They will discuss the findings with people who have recently used urgent medical services before developing any future changes to care.
Who supports and leads the study?
All members of the PIONEER Data Trust Committee supported this project.
The study is led by Dr Vinay Reddy-Kolanu, a consultant in acute medicine who leads the acute medicine service at Queen Elizabeth Hospital Birmingham. Acute medicine involves assessing and treating people with urgent medical problems. He is working with researchers from University Hospitals Birmingham and the University of Birmingham.
