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The following is a summary of  “How do emergency departments respond to ambulance pre-alert calls? A qualitative exploration of the management of pre-alerts in UK emergency departments,” published in the September 2024 issue of Emergency Medicine by Long et al.

Pre-alerts from ambulances can improve patient outcomes for time-critical conditions. Still, their effectiveness for other patients and the specific Emergency department (ED) response processes must be better understood.

Researchers conducted a retrospective study to understand how pre-alerts impact patient care in the ED.

They analyzed non-participants (162 hours, 143 pre-alerts) and semi-structured interviews with staff (n=40) in 6 UK EDs between August 2022 and April 2023. The focus was on how ED staff respond to pre-alert calls and the factors affecting the response. Observation notes and interview transcripts were examined by a thematic approach after being imported into NVivo.

The results showed that pre-alert calls required time and resources from ED staff but were appreciated for enabling preparation for patient arrival. High demand and handover delays led to improved pre-alerts due to ambulance clinician concerns about patient wait times. Despite the risk of pre-alert fatigue, ED clinicians appreciated timely information, considering underalerting more risky than overalerting. Individual and organizational factors affected ED response deviation, particularly resource availability. Indefinite ED processes for receiving, documenting, and sharing pre-alert information elevated the risk of information loss.

They concluded improving pre-alert information processes and providing alternative advice routes for ambulance clinicians could improve ED preparation and pre-alert appropriateness.

Source: emj.bmj.com/content/early/2024/09/17/emermed-2023-213854