Comparing physician associates and foundation year two doctors-in-training undertaking emergency medicine consultations in England: a mixed-methods study of processes and outcomes
| Autor: | Philip Begg, Chao Wang, Mary Halter, James Parle, James Ennis, Heather Gage, Simon de Lusignan, Vari Drennan, Laura Nice, Jonathan Gabe, Sally Brearley, Carly Wheeler |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Intraclass correlation Patient characteristics organisation of health services quality in health care Primary outcome Physicians Chart review Patient experience accident & emergency medicine medicine Humans Referral and Consultation Retrospective Studies business.industry Foundation (evidence) General Medicine Emergency department Triage England Emergency medicine Emergency Medicine Medicine Emergency Service Hospital business |
| Zdroj: | BMJ Open, Vol 10, Iss 9 (2020) BMJ Open |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2020-037557 |
| Popis: | ObjectivesTo compare the contribution of physician associates to the processes and outcomes of emergency medicine consultations with that of foundation year two doctors-in-training.DesignMixed-methods study: retrospective chart review using 4 months’ anonymised clinical record data of all patients seen by physician associates or foundation year two doctors-in-training in 2016; review of a subsample of 40 records for clinical adequacy; semi-structured interviews with staff and patients; observations of physician associates.SettingThree emergency departments in England.ParticipantsThe records of 8816 patients attended by 6 physician associates and 40 foundation year two doctors-in-training; of these n=3197 had the primary outcome recorded (n=1129 physician associates, n=2068 doctor); 14 clinicians and managers and 6 patients or relatives for interview; 5 physician associates for observation.Primary and secondary outcome measuresThe primary outcome was unplanned re-attendance at the same emergency department within 7 days. Secondary outcomes: consultation processes, clinical adequacy of care, and staff and patient experience.ResultsRe-attendances within 7 days (n=194 (6.1%)) showed no difference between physician associates and foundation year two doctors-in-training (OR 0.87, 95% CI 0.61 to 1.24, p=0.437). If seen by a physician associate, patients were more likely receive an X-ray investigation (OR 2.10, 95% CI 1.72 to 4.24), pConclusionsPhysician associates in emergency departments in England treated patients with a range of conditions safely, and at a similar level to foundation year two doctors-in-training, providing clinical operational efficiencies. |
| Databáze: | OpenAIRE |
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