Emergency Care Practitioners' clinical decision-making: how accurate is it?

This study set out to evaluate the accuracy of Emergency Care Practitioners’ (ECP) opinions as to whether their actions result in patients avoiding attendance at an emergency department (ED) or a hospital admission. The authors argue that the difference in these two outcomes is important as they have different implications for patients and the healthcare system in relation to patients’ experiences, use of resources, and economic cost.

Based in Great Western Ambulance Service NHS Trust, this research builds on previous audit data and examines whether, having treated a patient on scene, ECPs believed that their clinical decision resulted in the avoidance of an ED attendance or hospital admission. In addition, the researchers wanted to compare these findings with those of an ED consultant and a General Practitioner (GP) in order to establish whether there was agreement between the three professional groups.

In total, seven participants (four paramedics; three nurses) took part in the study which was undertaken over a 10-week period from 1st September 2009. The ECPs completed a patient care record (PCR) for each of their patients, and they documented whether their actions resulted in avoidance of either an ED attendance or hospital admission.