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Investigating the referral of patients with non-urgent conditions to a regional Australian emergency department: a study protocol


Unwin, M and Crisp, E and Rigby, S and Kinsman, L, Investigating the referral of patients with non-urgent conditions to a regional Australian emergency department: a study protocol, BMC Health Services Research, 18 Article 647. ISSN 1472-6963 (2018) [Contribution to Refereed Journal]


Copyright Statement

Copyright 2018 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1186/s12913-018-3411-4


Background: Australia’s only island state, Tasmania, experiences one of the nation’s highest incidences of non-urgent emergency department (ED) presentations in a healthcare system regularly faced with service demands that exceed resource availability. Service-demand mismatches are acknowledged to contribute to ED crowding which in turn, has been documented to have a correlation with poorer patient outcomes. Crowding within EDs is complex, non-urgent presentations alone are not the primary cause, but have been reported to be a contributing factor. In 2015–16 Tasmania recorded over 153,000 ED attendances, 55% of these fell into the two least urgent triage categories. Recent research in the State’s North established that 29% of non-urgent presentations were referred, formally or informally, from primary healthcare providers and that, for many patients (39%), the ED was not their first choice of service provider. This study aims to identify the service needs of patients referred to a regional Australian ED and subsequently triaged as non-urgent.

Method: In order to achieve this aim, three objectives have been identified. The first two objectives use an explanatory sequential mixed-method approach while the third objective will incorporate an implementation science approach. These three objectives are: first, a retrospective analysis of seven years of routinely collected hospital data to identify trends in referral of patients with non-urgent conditions; second, focus group interviews with patients and primary care providers to further understand perceived need and service requirements of those referred to the ED, and third, translation of findings into local health service recommendations.

Discussion: Identification of the needs of patients referred to the ED with non-urgent conditions will inform future service planning aiming to facilitate access to the right service at the right time and in the right place.

Item Details

Item Type:Contribution to Refereed Journal
Keywords:emergency department, non-urgent presentations, referral, primary care, general practitioner
Research Division:Health Sciences
Research Group:Nursing
Research Field:Nursing not elsewhere classified
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Unwin, M (Dr Maria Unwin)
UTAS Author:Crisp, E (Dr Elaine Crisp)
UTAS Author:Kinsman, L (Professor Leigh Kinsman)
ID Code:127914
Year Published:2018
Web of Science® Times Cited:4
Deposited By:Health Sciences
Deposited On:2018-08-22
Last Modified:2019-12-23
Downloads:72 View Download Statistics

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