Emergency admission predictive risk stratification models: assessment of implementation consequences (PRISMATIC 2): protocol for a mixed methods study.

Journal article

Kingston, M., Snooks, Helen, Watkins, Alan, Burton, Christopher, Dale, Jeremy, Davies, Jan, Dearden, Alex, Evans, Bridie, Santos Gomes, B., Jones, Jenna, Kumar, Rashmi, Porter, Alison, Sewell, Bernadette and Wallace, E. 2024. Emergency admission predictive risk stratification models: assessment of implementation consequences (PRISMATIC 2): protocol for a mixed methods study. British Journal of General Practice Open (BJGP Open). https://doi.org/10.3399/BJGPO.2024.0182
AuthorsKingston, M., Snooks, Helen, Watkins, Alan, Burton, Christopher, Dale, Jeremy, Davies, Jan, Dearden, Alex, Evans, Bridie, Santos Gomes, B., Jones, Jenna, Kumar, Rashmi, Porter, Alison, Sewell, Bernadette and Wallace, E.
AbstractEmergency admissions are costly, increasingly numerous, and associated with adverse patient outcomes. Policy responses have included the widespread introduction of emergency admission risk stratification (EARS) tools in primary care. These tools generate scores that predict patients' risk of emergency hospital admission and can be used to support targeted approaches to improve care and reduce admissions. However, the impact of EARS is poorly understood and there may be unintended consequences. To assess effects, mechanisms, costs, and patient and healthcare professionals' views related to the introduction of EARS tools in England. Quasi-experimental mixed methods design using anonymised routine data and qualitative methods. We will apply multiple interrupted time series analysis to data, aggregated at former Clinical Commissioning Group level, to look at changes in emergency admission and other healthcare use following EARS introduction across England. We will investigate GP decision-making at practice level using linked general practice and secondary care data to compare case-mix, demographics, indicators of condition severity and frailty associated with emergency admissions before and after EARS introduction. We will undertake interviews ( ~48) with GPs and healthcare staff to understand how patient care may have changed. We will conduct focus groups ( =2) and interviews ( ~16) with patients to explore how they perceive that communication of individual risk scores might affect their experiences and health seeking behaviours. Findings will provide policymakers, healthcare professionals, and patients, with a better understanding of the effects, costs and stakeholder perspectives related to the introduction of EARS tools. [Abstract copyright: Copyright © 2024, The Authors.]
KeywordsHealth services research; Emergency health services; Primary health care
Year2024
JournalBritish Journal of General Practice Open (BJGP Open)
PublisherRoyal College of General Practitioners
ISSN2398-3795
Digital Object Identifier (DOI)https://doi.org/10.3399/BJGPO.2024.0182
https://doi.org/BJGPO.2024.0182
Official URLhttps://bjgpopen.org/content/bjgpoa/early/2024/09/15/BJGPO.2024.0182.full.pdf
Publication dates
Online16 Sep 2024
Publication process dates
Accepted05 Aug 2024
Deposited02 Oct 2024
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Burton, C. and Rycroft-Malone, J. 2014. Resource based view of the firm as a theoretical lens on the organisational consequences of quality improvement. International Journal of Health Policy and Management. 3 (3), pp. 113 - 115. https://doi.org/10.15171/ijhpm.2014.74
The study protocol of: 'Initiating end of life care in stroke: clinical decision-making around prognosis'.
Burton, C., Payne, S., Turner, M., Bucknall, T., Rycroft-Malone, J., Tyrell, P., Horne, M., Ntambwe, L.I., Tyson, S., Mitchell, H., Williams, S. and Elghenzai, S. 2014. The study protocol of: 'Initiating end of life care in stroke: clinical decision-making around prognosis'. BMC Palliative Care. 13 (55). https://doi.org/10.1186/1472-684X-13-55
Identifying continence options after stroke (ICONS): a cluster randomised controlled feasibility trial.
Thomas, L.H., Watkins, C.L., Sutton, C.J., Forshaw, D., Leathley, M.J., French, B., Burton, C., Cheater, F., Roe, B., Britt, D., Booth, J., McColl, E., The ICONS Project Team and The ICONS Patient, Public and Carer Involvement Groups 2014. Identifying continence options after stroke (ICONS): a cluster randomised controlled feasibility trial. Trials. 15 (509). https://doi.org/10.1186/1745-6215-15-509
What is rehabilitation potential? Development of a theoretical model through the accounts of healthcare professionals working in stroke rehabilitation services
Burton, C.R., Horne, M., Woodward-Nutt, K., Bowen, A. and Tyrrell, P. 2014. What is rehabilitation potential? Development of a theoretical model through the accounts of healthcare professionals working in stroke rehabilitation services. Disability and Rehabilitation. 37 (21), pp. 1955-1960. https://doi.org/10.3109/09638288.2014.991454