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Article
Publication date: 14 May 2024

Mike Brady, Mark Conrad Fivaz, Peter Noblett, Greg Scott and Chris Olola

Most UK ambulance services undertake remote assessments of 999 calls with nurses and paramedics to manage demand and reduce inappropriate hospital admissions. However, little is…

Abstract

Purpose

Most UK ambulance services undertake remote assessments of 999 calls with nurses and paramedics to manage demand and reduce inappropriate hospital admissions. However, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they offer.

Design/methodology/approach

The retrospective descriptive study analysed data collected at Welsh Ambulance Services University NHS Trust (WAST) from prioritisation, triage, and audit tools between the 17th May 2022 to 8th November 2022. A total of 21,076 cases and 728 audits were included for review.

Findings

There was little difference in the type and frequency of the presenting complaints assessed, and clinical outcomes reached in percentage terms. Whilst paramedics had more highly compliant call audits and fewer non-compliant call audits, there was, again, little difference in percentage terms between the two, indicating positive levels of safety across the two professional groups.

Research limitations/implications

There continues to be a substantial difference between UK paramedics to those in the Middle East, the United States, and some African nations, which may limit the applicability of findings. This study also looked at a six-month window from only one UK service using one type of prioritisation and triage tool. Future research could explore longer periods from multiple services using various tools. It is important to note that this study did not link outcome data with primary, secondary or tertiary care settings. Thus, it is impossible to determine if the level of care aligned closely with the final diagnosis.

Practical implications

The practical implications of this work include better workforce planning for agencies who have perhaps only employed one type of clinician or a reaffirmation to those who have employed both. The authors suggest that the training and education of both sets of clinicians could remain general in nature, with no overt requirement for specificity based on professional registration alone. Commissioners and stakeholders in the wider health economy should consider ensuring equitable access to alternative pathways for patients assessed by both nurses and paramedics.

Social implications

It has been posited that UK nurses and paramedics are, by virtue of their consistency in education, skill set, licensure, and general experience, both able to achieve safe and effective remote outcomes in 999 settings. This study provides evidence to support that hypothesis. These results say more about the two professions' ability to work together rather than just the professions themselves. The multidisciplinary team approach is well-established in acute care settings, and is broadly considered to improve communication, coordination decision making, adherence to up-to-date treatment recommendations, and be positive for shared learning and development for younger colleagues.

Originality/value

Most UK services use a mix of nurses and paramedics; however, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they each offer. The most recent studies of this nature were published in 2003 and 2004 and looked only at low-acuity 999 calls when remote assessment was not even an established role for UK paramedics. This study updates the literature, identifies areas for future research, and applies to the international setting for the most part.

Details

International Journal of Emergency Services, vol. 13 no. 2
Type: Research Article
ISSN: 2047-0894

Keywords

Content available

Abstract

Details

International Journal of Emergency Services, vol. 13 no. 2
Type: Research Article
ISSN: 2047-0894

Open Access
Article
Publication date: 3 June 2024

Zhening Liu, Alistair Brandon-Jones and Christos Vasilakis

The purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the…

Abstract

Purpose

The purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the significant expansion in this and other forms of telehealth worldwide over the last decade. We use our analysis of the literature to develop a comprehensive framework that incorporates the patient journey, multidimensionality, antecedents and consequences, interventions and improvement options, as well as the cyclic nature of patient engagement. We also propose measures suitable for empirical assessment of different aspects of our framework.

Design/methodology/approach

We undertook a comprehensive review of the extant literature using a systematic review approach. We identified and analysed 63 articles published in peer-reviewed scientific journals between 2003 and 2022.

Findings

We conceptualise patient engagement with remote consultation across three key aspects: dimensions, process, and the antecedents and consequences of engagement. We identify nine contextual categories that influence such engagement. We propose several possible metrics for measuring patient engagement during three stages (before service, at/during service and after service) of remote consultation, as well as interventions and possible options for improving patient engagement therein.

Originality/value

The primary contribution of our research is the development of a comprehensive framework for patient engagement in remote consultation that draws on insights from literature in several disciplines. In addition, we have linked the three dimensions of engagement with the clinical process to create a structure for future engagement assessment. Furthermore, we have identified impact factors and outcomes of engagement in remote consultation by understanding which can help to improve levels of adoption, application and satisfaction, and reduce healthcare inequality. Finally, we have adopted a “cyclic” perspective and identified potential interventions that can be combined to further improve patient engagement in remote consultation.

Details

International Journal of Operations & Production Management, vol. 44 no. 13
Type: Research Article
ISSN: 0144-3577

Keywords

Open Access
Article
Publication date: 8 May 2024

Rolien Terblanche and Dorcas Khumalo

The objective of this study is to determine how biophilic designs in study areas affect the productivity of students at the University of the Witwatersrand. The study also seeks…

1150

Abstract

Purpose

The objective of this study is to determine how biophilic designs in study areas affect the productivity of students at the University of the Witwatersrand. The study also seeks to evaluate study areas at Wits in terms of biophilic design, determine whether biophilic design contributes to the preference of students and their study productivity.

Design/methodology/approach

This is a cross sectional study that used a mixed methodology. Five study areas were identified and evaluated in terms of biophilic design. At each study area, nine students participated in an open- and close-ended questionnaire regarding their perceptions on study areas and productivity.

Findings

The five study areas scored the following results according to the biophilic test: 29.09%, 34.55%, 36.36%, 80.00% and 85.45%, respectively. The students prefer to study in biophilic study areas as it prompts positive emotions and make them feel rejuvenated and energized. However, there are still students studying in the non-biophilic areas due to convenience or due to the biophilic areas that are noisy and lacks monitoring.

Research limitations/implications

With the small sample size, the generalizability of the findings are limited, but does create a foundation for further research.

Practical implications

Universities can learn from the findings and benefit greatly from many biophilic study areas. This could also encourage architects and interior designers to include biophilic design more so in general buildings/rooms.

Originality/value

Study areas at the University of the Witwatersrand was evaluated in terms of biophilic design, while determining whether biophilic design contributes to the preference of students and study productivity.

Details

Archnet-IJAR: International Journal of Architectural Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2631-6862

Keywords

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