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ED Organisation and Overcrowding

OUR RESEARCH AND PAPERS

 Primary Care Foundation report on urgent care centres and emergency departments, including literature synthesis by WMS (in progress)

Primary Care Foundation report on primary care in emergency departments, including literature synthesis by WMS (released Friday 5/3/10)

Urgent Care - evidence to support the development of a new urgent care system. Overview and full report available.

Systematic Review - Reducing waits and Attendances at A&E 2004

Briefing and Overview 2006 - How to reduce ED waits and sustain them

Cooke MW DH and research agree on time definitionseEMJ 2006

MW Cooke, S Black, A Fletcher, M Jennings Flows through beds not occupancy Emerg Med Journ 2005

M W Cooke, S Wilson, J Halsall, and A Roalfe Total time in English accident and emergency departments is related to bed occupancy Emerg Med J 2004 21: 575-576 

Chris Salisbury, Sandra Hollinghurst, Alan Montgomery, Matthew Cooke, James Munro, Deborah Sharp, and Melanie Chalder The impact of co-located NHS walk-in centres on emergency departmentsEmerg Med J 2007; 24: 265-269

Downing A, Wilson RC, Cooke MW. Which patients spend more than 4 hours in the Accident and Emergency department? J Public Health (Oxf). 2004 Jun;26(2):172-6.

MW Cooke Reforming the UK Emergency Care System Emerg Med J 2003;20:112-117

K Castille & MW Cooke See and Treat - one size does not fit all Emerg Med J 2003;20:118-121

MW Cooke, P Arora, and SM Mason Discharge from triage - Modelling the potential in different types of Emergency Department Emerg Med J 2003;20:130-132 

MW Cooke, J Higgins, P Kidd The use of emergency observation and assessment wards: a systematic literature review. Emerg Med J 2003;20:137-142 

Cooke M, Castille K. Emergency pyramid is inverting already. BMJ. 2003 Jan 4;326(7379):49.

Cooke M. Emergency medicine. Whole system is responsible for solving overcrowding of departments. BMJ. 2002 Aug 17;325(7360):389;

Cooke MW, Wilson S, Pearson S. The effect of a separate stream for minor injuries on accident and emergency department waiting times. Emerg Med J. 2002 Jan;19(1):28-30.

see also Matthew Cooke's presentations

 

Organisation and service delivery in emergency departments undertaken by WECR

English ED total time data Present total time data. Past data.

The result of the CQIs are available here with unverifed weekly data is also available here
with the original guidance available here
With best practice here
More recent data on quality indicators is available on individual NHS Trust websites.

OTHER SOURCES

College of Emergency Medicine- resources on ED overcrowding (needs log in)

Systematic review on waits in ED. Annals Emerg Med 2008

Reducing unplanned hospital admissions a systematic review 2006

Harvard review on the UK four hour target 2007

 

BMA report on ED waits 2007

 

CANADA status and causes 2005  HTA canada report - issues and solutions 2006

USA - US Governvernment Accountability Office Report April 2009: how long do you spend in the ED June2006

 

Overcrowding increases mortality 3 MJA articles March2006 

Presentation Reforming Emergency Care- the UK experience. Nice, September 2005 (!!1.2 megabyte file)

Examples- KPI for emergency care and Toolkit to assess clinician staffing levels

Samples of CDU care pathways from Leeds and Birmingham (LARGE zip file, 1.5Mb)

Redusing Waits conference Edinburgh 2009

The Warwick Emergency Care Conferences have also discussed issues of waits in 2003 and 2002

Data Definitions

Canadian Data Definitions ACEP (USA) Overcrowding information Australasian CEM definitions

NHS data dictionary NHS Emergency sitrep definitions