Laura R Joyce FACEM, AFRACMA, MBChB, BMed Sc(Hons), MMedEd, Marc Gutenstein FACEM, FDRHMNZ, BMBCh, MA(Hons), Mark Gilbert FACEM, MBChB, James Weaver FACEM, MBChB, Scott Pearson FACEM, MBChB, John W Pickering BSc(Hons), PhD, BA(Hons), Martin Than FACEM, MBBS
{"title":"评估虚拟紧急护理服务,以避免不必要的急诊科介绍,并提供专家主导的最终护理","authors":"Laura R Joyce FACEM, AFRACMA, MBChB, BMed Sc(Hons), MMedEd, Marc Gutenstein FACEM, FDRHMNZ, BMBCh, MA(Hons), Mark Gilbert FACEM, MBChB, James Weaver FACEM, MBChB, Scott Pearson FACEM, MBChB, John W Pickering BSc(Hons), PhD, BA(Hons), Martin Than FACEM, MBBS","doi":"10.1111/1742-6723.70048","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>A quantitative and qualitative evaluation of the impact of a peer-to-peer telehealth service called Specialist Telehealth Aotearoa (STAR) on transfers to the ED.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This mixed-methods study reviewed STAR between 31 July 2023 and 31 October 2023. Reasons for presentation and outcomes were analysed. Thematic analysis was used to examine responses to an electronic survey from referrers to the STAR service, exploring the benefits and barriers to engagement with the service.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Eight hundred and sixty-seven consultations occurred, with hospital transfer avoided for 500 (58%) patients. Fifty-one patients (10.2%) re-presented to Christchurch Hospital within 7 days with the same/related issue, similar to the overall hospital 7-day re-presentation rate of 9.5%. Survey responses were received from 130 ambulance staff and rural practitioners, with 97% reporting a ‘very good’ or ‘excellent’ experience with STAR. Thematic analysis of responses from referrers identified four main benefits: local FACEMs who understand the local context, mutual trust built on pre-existing relationships, empowering pre-hospital and rural clinicians and putting the patient first: providing right care–right place–right time.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>STAR prevented unnecessary transfers to ED with a 7-day representation rate comparable to the wider hospital. Referrers reported a number of benefits to the service, as well as identifying potential barriers to engagement. The integration of a specialist emergency care telehealth service into the health system could alleviate pressure on EDs in Aotearoa New Zealand.</p>\n </section>\n </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70048","citationCount":"0","resultStr":"{\"title\":\"Evaluation of a virtual emergency care service to avoid unnecessary emergency department presentations and provide specialist-led definitive care\",\"authors\":\"Laura R Joyce FACEM, AFRACMA, MBChB, BMed Sc(Hons), MMedEd, Marc Gutenstein FACEM, FDRHMNZ, BMBCh, MA(Hons), Mark Gilbert FACEM, MBChB, James Weaver FACEM, MBChB, Scott Pearson FACEM, MBChB, John W Pickering BSc(Hons), PhD, BA(Hons), Martin Than FACEM, MBBS\",\"doi\":\"10.1111/1742-6723.70048\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>A quantitative and qualitative evaluation of the impact of a peer-to-peer telehealth service called Specialist Telehealth Aotearoa (STAR) on transfers to the ED.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This mixed-methods study reviewed STAR between 31 July 2023 and 31 October 2023. Reasons for presentation and outcomes were analysed. Thematic analysis was used to examine responses to an electronic survey from referrers to the STAR service, exploring the benefits and barriers to engagement with the service.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Eight hundred and sixty-seven consultations occurred, with hospital transfer avoided for 500 (58%) patients. Fifty-one patients (10.2%) re-presented to Christchurch Hospital within 7 days with the same/related issue, similar to the overall hospital 7-day re-presentation rate of 9.5%. Survey responses were received from 130 ambulance staff and rural practitioners, with 97% reporting a ‘very good’ or ‘excellent’ experience with STAR. Thematic analysis of responses from referrers identified four main benefits: local FACEMs who understand the local context, mutual trust built on pre-existing relationships, empowering pre-hospital and rural clinicians and putting the patient first: providing right care–right place–right time.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>STAR prevented unnecessary transfers to ED with a 7-day representation rate comparable to the wider hospital. Referrers reported a number of benefits to the service, as well as identifying potential barriers to engagement. 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Evaluation of a virtual emergency care service to avoid unnecessary emergency department presentations and provide specialist-led definitive care
Objective
A quantitative and qualitative evaluation of the impact of a peer-to-peer telehealth service called Specialist Telehealth Aotearoa (STAR) on transfers to the ED.
Methods
This mixed-methods study reviewed STAR between 31 July 2023 and 31 October 2023. Reasons for presentation and outcomes were analysed. Thematic analysis was used to examine responses to an electronic survey from referrers to the STAR service, exploring the benefits and barriers to engagement with the service.
Results
Eight hundred and sixty-seven consultations occurred, with hospital transfer avoided for 500 (58%) patients. Fifty-one patients (10.2%) re-presented to Christchurch Hospital within 7 days with the same/related issue, similar to the overall hospital 7-day re-presentation rate of 9.5%. Survey responses were received from 130 ambulance staff and rural practitioners, with 97% reporting a ‘very good’ or ‘excellent’ experience with STAR. Thematic analysis of responses from referrers identified four main benefits: local FACEMs who understand the local context, mutual trust built on pre-existing relationships, empowering pre-hospital and rural clinicians and putting the patient first: providing right care–right place–right time.
Conclusions
STAR prevented unnecessary transfers to ED with a 7-day representation rate comparable to the wider hospital. Referrers reported a number of benefits to the service, as well as identifying potential barriers to engagement. The integration of a specialist emergency care telehealth service into the health system could alleviate pressure on EDs in Aotearoa New Zealand.
期刊介绍:
Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine.
Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.