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Table 2 Hospital sites - 2013

From: A qualitative study of the determinants of adherence to NICE falls guideline in managing older fallers attending an emergency department

 

Hospital A

Hospital B

Hospital catchment area

18.3 million emergency department attenders in 2013 in England.

Catchment area of approximately 1.1 million people.

Catchment area of between 450,000 and 650,000 people.

Hospital size

More than 1500 beds.

Less than 700 beds.

Number of ED attenders

Between 130,000 and 150,000 emergency department attenders.

January–December 2013.

400–500 patients seen per day.

Between 80,000 and 100,000 emergency department attenders. November 2012–December 2013.

100–300 patients seen per day.

City/town located:

 Average age of local population

Between 30 and 40.

Between 35 and 45.

 Male/female % representation of local population

Approximately 50/50 split.

Approximately 50/50 split.

 Ethnicity of local population

Between 60 and 70% born in England.

Between 80 and 90% born in England.

 Level of deprivation in catchment population.

Ranked in the top 20 most deprived areas in England.

Ranked below the 140 most deprived areas in England.

 Emergency department structure

The emergency departments comprised 3 sub-areas*:

1) Minors—an area in which patients with less serious injuries or illnesses were treated,

2) Majors—an area for treatment of non-ambulatory patients and those with potentially serious conditions;

3) ‘Resus’—for individuals who were seriously ill or injured.

 Standard treatment process

1) Patient presents.

2) Handover from ambulance crew (if at majors), or if at minors, present to receptionist and assigned to triage.

3) Patient triaged by an ED nurse.

4) Details input onto computer/written on whiteboard.

5) Patient seen by a junior doctor/advanced nurse practitioner (ANP), and a consultant, as required.

6) Patient receives treatment from nurse/healthcare assistant as directed, including investigations, e.g. ECG/blood tests.

7) If tests have been conducted, the results are assessed by a doctor/ANP to decide on the best treatment pathways.

8) Treated and discharged home/admitted, or transferred for further treatment (e.g. applying plaster cast) and then sent home/admitted.

 Emergency facilities for older frail patients, which they could be referred to post ED discharge*

Emergency frailty unit.

N/A

  1. *Observations took place in major and minor injury departments only. This was to focus the research on generic care within the ED, not specialist services