2245 Mixed methods study exploring factors influencing ambulance clinician decisions to pre-alert emergency departments (EDs) of a patients arrival

Conclusion Variation in pre-alert practice was not fully explained by casemix. Overall 142,795/1,363,274 conveyances were pre-alerted. Highest overall odds ratios (ORs) for pre-alert were associated with patient factors (working diagnosis OR:4.16,CI:4.05-4.26, NEWS2 OR:1.4,CI:1.39-1.4) but thresholds for pre-alerting varied between ambulance clinicians. Pre-alerts were more likely when there were longer turnaround times at EDs (OR:1.83,CI:1.69-1.98), potentially due to ambulance clinicians’ concerns about their ability to effectively manage deteriorating patients where long handovers were anticipated. There was a significant difference in pre-alert rates between EDs (figure 1) that was not explained by type of hospital (e.g. Major Trauma Centres). Anticipated ED response to pre-alerts had a significant impact on pre-alert decisions due to variation in ED protocols and expectations. Abstract 2245 Figure 1Odds ratio of pre-alert being made stratified by receiving hospital
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: RCEM Lightning Papers Source Type: research