Implementing a virtual emergency department to avoid unnecessary emergency department presentations

Author:

Kelly Jaimon T12ORCID,Mitchell Nicole34,Campbell Katrina L23,Furlong Karen45ORCID,Langley Matthew34,Clark Sean345,Rushbrook Elizabeth4,Hansen Kim46

Affiliation:

1. Centre for Online Health, Faculty of Medicine The University of Queensland Brisbane Queensland Australia

2. Centre for Health Services Research, Faculty of Medicine The University of Queensland Brisbane Queensland Australia

3. Healthcare Excellence and Innovation Metro North Hospital and Health Service Brisbane Queensland Australia

4. Virtual Emergency Department Metro North Hospital and Health Service Brisbane Queensland Australia

5. Caboolture Emergency Department Metro North Hospital and Health Service Brisbane Queensland Australia

6. Faculty of Medicine The University of Queensland Brisbane Queensland Australia

Abstract

AbstractObjectiveEDs are necessary for urgent health concerns; however, many physical ED visits could be better treated in alternate settings. The present study aimed to describe the feasibility, acceptability and effectiveness of a Virtual ED to reduce unnecessary physical ED presentations at a large tertiary health service in Australia.MethodsThis observational study using the RE‐AIM framework (Reach, Efficacy, Adoption, Implementation and Maintenance) evaluated the feasibility of a Virtual ED using routinely collected health service data and process‐evaluation to assess intervention fidelity and adherence between April 2020 and 31 March 2022. The primary outcome for the present study was the feasibility of the Virtual ED model of care.ResultsThe Virtual ED received 2080 direct calls for patients with a mean age of 50.3 years, with 70.4% managed in the Virtual ED alone and 29.6% referred for physical ED presentation. Of the 2080 direct referrals, 95.8% were potentially avoidable ED presentations. Of those referred, 28.3% required an admission. Of calls managed entirely by Virtual ED, 18 (1.2%) unexpectedly required a hospital admission within 48 h. General practitioner respondents rated the Virtual ED service as helpful to very helpful. The service had an average of 212 referrals per month, with a 65.2% average growth rate. The Virtual ED service was considered helpful and clinically appropriate, with a high level of ED avoidance.ConclusionThe Virtual ED prevented 70% of community triaged patients from presenting to the physical ED, with good uptake from all referrers, supporting the use of virtual care pathways in emergency care management.

Funder

National Heart Foundation of Australia

Publisher

Wiley

Subject

Emergency Medicine

Reference24 articles.

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