title: Using transprofessional care in the emergency department to reduce patient admissions: A retrospective audit of medical histories.
abstract: The demand for emergency department (ED) services has increased significantly, due to our increasingly ageing population and limited access to primary care. This article reports outcomes from a transprofessional model of care in an ED in Victoria, Australia. Nurses, physiotherapists, social workers, and occupational therapists undertook additional education to increase the range of services they could provide and thereby expedite patient flow through the ED. One hundred patients who received this service were matched against 50 patients who did not. The most common reasons for patient admission were limb injury/limb pain (n = 47, 23.5%) and falls (n = 46, 23.0%). Transprofessional interventions included applying supportive bandages, slings, zimmer splints and controlled ankle motion (CAM) boots, and referral to new services such as case management and mental health teams. The rate of hospital admissions was significantly lower in the transprofessional group (n = 27, 18.0%) than in the reference group (n = 19, 38%, p = 0.005). This group also had a slightly lower re-presentation rate (n = 4, 2.7%) than patients in the reference group (n = 2, 4.0%). There are many benefits that support this model of care that in turn reduces ED overcrowding and work stress. A transprofessional model may offer a creative solution to meeting the varied needs of patients presenting for emergency care.
authors.affiliation: a School of Nursing and Midwifery, Monash University , Frankston , Victoria , Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Morphet
authors.affiliation: a School of Nursing and Midwifery, Monash University , Frankston , Victoria , Australia.
authors.forename: Debra Lee
authors.initials: DL
authors.lastname: Griffiths
authors.affiliation: b School of Nursing and Midwifery , Monash University , Clayton , Victoria , Australia.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Crawford
authors.affiliation: b School of Nursing and Midwifery , Monash University , Clayton , Victoria , Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Williams
authors.affiliation: a School of Nursing and Midwifery, Monash University , Frankston , Victoria , Australia.
authors.forename: Tamsin
authors.initials: T
authors.lastname: Jones
authors.affiliation: c Hospital Admission Risk Program (HARP), Peninsula Health , Frankston , Victoria , Australia.
authors.forename: Belinda
authors.initials: B
authors.lastname: Berry
authors.affiliation: a School of Nursing and Midwifery, Monash University , Frankston , Victoria , Australia.
authors.forename: Kelli
authors.initials: K
authors.lastname: Innes
mesh_terms: D003299:Cooperative Behavior; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007400:Interprofessional Relations; D009740:Nursing Staff / Q000458:organization & administration; D009788:Occupational Therapy / Q000458:organization & administration; D010343:Patient Admission / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000458:organization & administration* / Q000706:statistics & numerical data; D059825:Physical Therapists / Q000458:organization & administration; D012189:Retrospective Studies; D000068217:Social Workers; D013192:Staff Development / Q000458:organization & administration; D013997:Time Factors; D014739:Victoria; D057188:Workflow
keywords: Collaboration; emergency department; patient outcomes; teamwork; transprofessional