OPTI-MEND: Optimising early assessment and intervention by health and social care professionals in the emergency department (ED)

Emergency Departments (ED) face significant challenges in delivering high quality and timely patient care against a background of increasing patient numbers and limited hospital resources. A mismatch between patient demand and the hospital's capacity often leads to poor patient flow and ED crowding, resulting in a reduction in the quality, safety and effectiveness of care delivered. The reasons for the increase in ED visits are multifaceted and the number of ED attendees is projected to continue to increase in the future. To this end, a number of initiatives have been introduced in the ED coupled with time-sensitive targets to improve the transition and timeliness of care. The overall aim of this study is to determine and measure the impact of early assessment and intervention by a multidisciplinary Health and Social Care Professions (HSCP) team in the ED in enhancing the quality of patient care by safely avoiding a hospital admission, improving the patient experience and optimising overall patient flow. To achieve this, we will firstly set the scene by reviewing the existing international literature regarding the effectiveness of HSCP interventions and contextualise these findings by describing the flow of patients who attend a large Irish ED without a dedicated HSCP team in the ED. We will also conduct interviews with a range of stakeholders including ED patients and their families, HSCPs and pre-hospital staff to explore the problems with current models of care and how they believe the situation could be improved with HSCP intervention. This information will help us to develop a user-informed and evidence-based HSCP intervention for target ED populations that will be evaluated using a controlled-before-after study. This timely work will inform healthcare practitioners and decision-makers regarding the most clinical and potentially cost-effective intervention(s) to optimise the quality of ED care.

Award Date: 28 September 2017
Award Value: €277166
Principal Investigator: Dr Rose Galvin
Host Institution: University of Limerick
Scheme: Research Collaborative in Quality and Patient Safety