Articles: emergency-department.
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Editorial Review
Taxonomy of the form and function of primary care services in or alongside emergency departments: concepts paper.
Primary care services in or alongside emergency departments look and function differently and are described using inconsistent terminology. Research to determine effectiveness of these models is hampered by outdated classification systems, limiting the opportunity for data synthesis to draw conclusions and inform decision-making and policy. We used findings from a literature review, a national survey of Type 1 emergency departments in England and Wales, staff interviews, other routine data sources and discussions from two stakeholder events to inform the taxonomy. ⋯ We then describe a conceptual spectrum of integration: identifying constructs that influence how the services function-from being closer to an emergency medicine service or to usual primary care. This taxonomy provides a basis for future evaluation of service models that will comprise the evidence base to inform policy-making in this domain. Commissioners and service providers can consider these constructs in characterising and designing services depending on local circumstances and context.
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For the London Olympic and Paralympic Games in 2012, a sentinel ED syndromic surveillance system was established to enhance public health surveillance by obtaining data from a selected network of EDs, focusing on London. In 2017, a new national standard Emergency Care Dataset was introduced, which enabled Public Health England (PHE) to initiate the expansion of their sentinel system to national coverage. Prior to this initiative, we estimated the added value, and potential additional resource use, of an expansion of the sentinel surveillance system. ⋯ We have quantified the added value of national ED syndromic surveillance systems, showing how they will enable detection of more localised events. Furthermore, national systems add value in enabling timelier public health interventions. Finally, we have highlighted areas where extra resource may be required to manage improvements in detection coverage.