HIGHLIGHTS
- A high number of cases that could be handled by general practitioners are presented at emergency departments.
- Abt designed and implemented an evaluation of the involvement of nurse practitioners.
- Abt’s report raised the need for continuing the program and offered recommendations to improve the program.
The Challenge
A high number of non-urgent cases that could be addressed by general practice (GP) doctors are presenting unnecessarily at hospital emergency departments (EDs); these are potentially avoidable. Strategies that can save ED health professionals’ time also can lead to more efficient services and appropriate care. There is strong evidence that providing an opportunity to seek support from a nurse practitioner (NP) within an ED can reduce the burden on medical staff in EDs. Abt Global was engaged to evaluate how well the nurse practitioner approach works in the Gympie Hospital ED, and how could it be improved.
The Approach
Abt conceptualised and developed a plan for an impact evaluation. A mixed methodology approach was employed. De-identified hospital data regarding the type and timing of the presentation, and details regarding the outcome of the consult was analysed to measure the project’s outcomes. Multiple stakeholders were interviewed to understand their observations and perception of the program’s effectiveness and the efficiency of the overall system.
The Results
The Gympie Hospital ED needed to compensate for limited availability of GP services in the region. The results indicated that there was a relatively higher number of GP-type presentations that should not be managed in an ED. The NP model was effective in meeting the service demand and reducing the overall burden on the ED within normal hours as well as after hours. It also increased NPs’ skills and knowledge, as well as their collaboration and coordination with doctors, thereby improving the ED’s capabilities.