Linked Projects

Improving the speed and appropriateness of treatment in Emergency Departments using evidence based methods such as Senior Doctor Triage

Working in collaboration with the Academic Health Science Network (AHSN) Improvement Academy, this 2-year improvement project is focusing on senior doctor triage in the emergency department (ED). Of the 19 EDs in Yorkshire and the Humber, 17 have been visited and data collected on existing front door services used. This overview has enabled good practice to be identified and shared with colleagues throughout the region. The current stage of the project is working with York Hospitals NHS Trust to improve their triage model for patients attending York Hospital. The ED is currently testing senior doctor triage for patients arriving by ambulance. The process is being constantly measured using various indicators to identify if improvements are taking place in patient care and staff are now working to implement 'The Perfect Week' in the Ambulance Assessment Area based on the success of the senior doctor triage model.

Principal investigator: Professor Suzanne Mason (s.mason@sheffield.ac.uk)
Programme Manager: Maxine Kuczawski (m.kuczawski@sheffield.ac.uk)
Project start date: 01/11/2014
Anticipated completion date: 31/07/2016
Status: Open.

A qualitative scoping study of emergency and urgent care stakeholders in Yorkshire & Humber

A qualitative study is underway across Yorkshire and Humber to understand the key challenges facing the emergency and urgent care system in the region. Over 40 interviews have been completed with a range of EUC stakeholders including clinicians, nurses and managers from a range of providers including the ambulance service, emergency departments (EDs), acute medical units, primary care and community care. Analysis of the data has established the importance of leadership and roles that cross different healthcare provider boundaries, which can play a key role in developing initiatives to respond to surges in demand in the system. Further analysis is ongoing to identify variation in service provision to be mapped to variation in system performance identified by our data analysis.

Principal investigator: Professor Suzanne Mason (s.mason@sheffield.ac.uk)
Project start date: 01/05/2014
Completion date: 31/12/2015
Status: Closed. Follow-up complete.

Mental health nurse triage for Ambulance Service patients with mental health problems

A collaborative theme project with the Yorkshire Ambulance Service has explored the care provided for 999 patients with mental health problems. This included an evaluation of a pilot study of mental health nurse triage within the Emergency Operations Centre. The evaluation assessed the impact of the service on outcomes for patients and on the working practices of Ambulance Service staff. Routine data indicates that this initiative reduces avoidable dispatch of an ambulance response. Interviews revealed the developmental process and challenges involved in implementing the initiative. Staff perceived initial benefits in relation to the delivery of more appropriate patient care and reduced anxiety for staff managing calls that now have access to specialist support.


Principal investigator: Professor Suzanne Mason (s.mason@sheffield.ac.uk)
Project start date: 01/07/2014
Completion date: 31/12/2015
Status: Closed. Follow-up complete.

Unscheduled admissions for suspected seizures

The more appropriate treatment of suspected seizure has the potential to reduce unscheduled admissions in this patient group. Pilot work with collaborators (including YAS) has demonstrated the feasibility of identifying a group of patients with seizure who may benefit from intervention to reduce admissions. The formation of a PPI group has also been established. The development of a national programme grant application to NIHR on unscheduled care of patients with seizure  is currently in progress.

Principal investigator: Jon Dickson (j.m.dickson@sheffield.ac.uk)
Project start date: 01/01/2014
Completion date: 31/12/2015
Status: Closed. Follow-up complete.

An evaluation of the factors contributing to why patients attend the Emergency Department at Barnsley Hospital NHS Foundation Trust 

A service evaluation was carried out at Barnsley Hospital using patient questionnaires, patient qualitative interviews and staff focus groups to investigate the processes involved in people using the hospital’s emergency department in order to inform the future direction of services. Over 900 patients attending A&E completed a questionnaire; the majority of people said they attended to gain reassurance about their condition and the visit was influenced by a lack of knowledge about where else to go and problems accessing GP appointments. A&E was viewed as being a more accessible and speedier alternative to a GP appointment. Staff identified referrals from primary care professionals and perceptions that hospital staff were better qualified to assess patients as reasons for attendance.


Principal investigator: Dawn Johnson 
Project start date: 01/01/2014
Completion date: 31/03/2015
Status: Closed. Follow-up complete.


Research Capability Funding

Frequent Emergency Department Attenders

It has been identified that many patients who frequently attend the ED have long-term health conditions, mental health problems or health related anxieties. The principal interventions developed to manage frequent users of emergency healthcare are aimed at individual case management, often using a multidisciplinary approach to agree the appropriate strategy. However, this approach is labour intensive and reaches a relatively small sample of the frequent attender population. This project aims to identify alternative interventions that could be delivered using less resource intensive methods.

Principal investigator: Professor Suzanne Mason (s.mason@sheffield.ac.uk)
Project start date: 01/07/2014
Anticipated completion date: 31/03/2016
Status: Closed. In follow-up.


Evaluating the impact of GP co-location across Yorkshire and the Humber on Emergency Department Workload


An exploratory study using surveys and qualitative interviews has been undertaken in Yorkshire and Humber to establish the proportion of EDs across the region that have co-located primary care services in ED, the types of models in operation and any barriers and facilitators to the success of these services. Analysis of data showed three innovative models: Primary Care Service Embedded within the ED, Urgent Care Centre and Nurse Practitioner Urgent Care Service. Level of integration of primary care services with ED, referral processes in hospital and sustainability were key factors to consider  when implementing co-located primary care services.

Principal investigator: Professor Suzanne Mason (s.mason@sheffield.ac.uk)
Project start date: 01/03/2015
Completion date: 31/12/2015
Status: Closed. Follow-up complete.


RCEM Competitive Grant

AHEAD2: Evaluating adverse outcome amongst patients following head injury who are taking the newer oral anticoagulant medications (NOACs) – A Pilot Study

Due to wide variation reported in the investigation, admission and subsequent management of anticogulation in patients taking the newer anticoagulants (NOACs), there is a need for further research in this area. This retrospective pilot study aims to explore the outcomes of patients taking NOACs after blunt head injury. Routine data is currently being collected from one Emergency Department based on methodology already tried and tested in a much larger AHEAD Study evaluating outcomes in patients on warfarin following head injury. The primary outcome of interest will be the rate of head injury complication. Following the completion of the pilot study, further funding will be sought to undertake this research in Emergency Departments across the UK.

Principal investigator: Professor Suzanne Mason (s.mason@sheffield.ac.uk)
Project start date: 01/12/2015
Anticipated completion date: 30/11/2016
Status: In set-up.