TY - JOUR
T1 - General practitioners and emergency departments (GPED) - Efficient models of care
T2 - A mixed-methods study protocol
AU - Morton, Katherine
AU - Voss, Sarah
AU - Adamson, Joy
AU - Baxter, Helen
AU - Bloor, Karen
AU - Brandling, Janet
AU - Cowlishaw, Sean
AU - Doran, Tim
AU - Gibson, Andrew
AU - Gutacker, Nils
AU - Liu, Dan
AU - Purdy, Sarah
AU - Roy, Paul
AU - Salisbury, Christopher
AU - Scantlebury, Arabella
AU - Vaittinen, Anu
AU - Watson, Rose
AU - Benger, Jonathan Richard
N1 - Funding Information:
Funding This work was supported by the National Institute of Health Research (NIHR) Health services and Delivery Research (HS&DR) Programme, project number 15/145/06.
Publisher Copyright:
© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Introduction Pressure continues to grow on emergency departments in the UK and throughout the world, with declining performance and adverse effects on patient outcome, safety and experience. One proposed solution is to locate general practitioners to work in or alongside the emergency department (GPED). Several GPED models have been introduced, however, evidence of effectiveness is weak. This study aims to evaluate the impact of GPED on patient care, the primary care and acute hospital team and the wider urgent care system. Methods and analysis The study will be divided into three work packages (WPs). WP-A; Mapping and Taxonomy: Mapping, description and classification of current models of GPED in all emergency departments in England and interviews with key informants to examine the hypotheses that underpin GPED. WP-B; Quantitative Analysis of National Data: Measurement of the effectiveness, costs and consequences of the GPED models identified in WP-A, compared with a no-GPED model, using retrospective analysis of Hospital Episode Statistics Data. WP-C; Case Studies: Detailed case studies of different GPED models using a mixture of qualitative and quantitative methods including: non-participant observation of clinical care, semistructured interviews with staff, patients and carers; workforce surveys with emergency department staff and analysis of available local routinely collected hospital data. Prospective case study sites will be identified by completing telephone interviews with sites awarded capital funding by the UK government to implement GPED initiatives. The study has a strong patient and public involvement group that has contributed to study design and materials, and which will be closely involved in data interpretation and dissemination. Ethics and dissemination The study has been approved by the National Health Service East Midlands - Leicester South Research Ethics Committee: 17/EM/0312. The results of the study will be disseminated through peer-reviewed journals, conferences and a planned programme of knowledge mobilisation.
AB - Introduction Pressure continues to grow on emergency departments in the UK and throughout the world, with declining performance and adverse effects on patient outcome, safety and experience. One proposed solution is to locate general practitioners to work in or alongside the emergency department (GPED). Several GPED models have been introduced, however, evidence of effectiveness is weak. This study aims to evaluate the impact of GPED on patient care, the primary care and acute hospital team and the wider urgent care system. Methods and analysis The study will be divided into three work packages (WPs). WP-A; Mapping and Taxonomy: Mapping, description and classification of current models of GPED in all emergency departments in England and interviews with key informants to examine the hypotheses that underpin GPED. WP-B; Quantitative Analysis of National Data: Measurement of the effectiveness, costs and consequences of the GPED models identified in WP-A, compared with a no-GPED model, using retrospective analysis of Hospital Episode Statistics Data. WP-C; Case Studies: Detailed case studies of different GPED models using a mixture of qualitative and quantitative methods including: non-participant observation of clinical care, semistructured interviews with staff, patients and carers; workforce surveys with emergency department staff and analysis of available local routinely collected hospital data. Prospective case study sites will be identified by completing telephone interviews with sites awarded capital funding by the UK government to implement GPED initiatives. The study has a strong patient and public involvement group that has contributed to study design and materials, and which will be closely involved in data interpretation and dissemination. Ethics and dissemination The study has been approved by the National Health Service East Midlands - Leicester South Research Ethics Committee: 17/EM/0312. The results of the study will be disseminated through peer-reviewed journals, conferences and a planned programme of knowledge mobilisation.
KW - evaluation
KW - mixed-methods
KW - primary care
KW - urgent care
UR - http://www.scopus.com/inward/record.url?scp=85054436228&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-024012
DO - 10.1136/bmjopen-2018-024012
M3 - Article
C2 - 30287675
AN - SCOPUS:85054436228
SN - 2044-6055
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 10
M1 - e024012
ER -