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Mrs Andrews' story: Her failed care pathway

Health Service Journal follows Mrs Andrews' story, an 84-year-old woman who, after falling over in the bathroom, spent seven weeks in hospital which subsequently meant she never went home. Her failed care pathway illustrates why we should have more care and support for people like her outside hospital and that those services need to respond much earlier to people's needs.


Mrs Andrews' Story – what went wrong?


The A&E 'Brand'

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Bunn, J., Croft, S., O’Keeffe, C., Jacques, R., Simpson, R., Stone, T., Conroy, S., Mason, S. (2018) Urgent care axis for the older adult: where is best to target interventions? Emerg Med J 2018;0:1–5. doi:10.1136/emermed-2018-207505

Wright, B., Martin. G., Ahmed, A., Banerjee, J., Mason, S., Roland, D. (2018). How the availability of observation status affects emergency physician decisionmaking. Annals of Emergency Medicine. 1-9. doi:10.1016/j.annemergmed.2018.04.023 


Abdulwahid, M., Turner, J., Mason S. (2018) Senior doctor triage (SDT), a qualitative study of clinicians’ views on senior doctors’ involvement in triage and early assessment of emergency patients. Emerg Med J Published Online First: 10 May 2018. doi: 10.1136/emermed-2017-207219

Heyworth, J., Mason, S. (2017). Emergency Medicine: great papers from the Summer of Love to 2017. Emerg Med J 2018;35:152-155. doi: 10.1136/emermed-2017-207285

O'Keeffe, C., Mason, S., Jacques, R. M., & Nicholl, J. (2018). Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data. PLoS ONE, 13(2). doi:10.1371/journal.pone.0192855

Cameron, A., Jones, D., Logan E., …Mason, S. et al (2017). Comparison of Glasgow Admission Prediction Score and Amb Score in predicting need for inpatient care. Emerg Med J Published Online First: 14 February 2018. doi: 10.1136/emermed-2017-207246

Crede, S. H., Such, E., & Mason, S. (2018). International migrants’ use of emergency departments in Europe compared with non-migrants’ use: a systematic review. European Journal of Public Health, 28(1), 61-73. doi:10.1093/eurpub/ckx057

Rimmer, M., Ablard, S., O’Keeffe, C., & Mason, S. (2017). 8 Different approaches needed to manage ED demand among different age-groups. Emergency Medicine Journal, 34(12), A865.2-A866. doi:10.1136/emermed-2017-207308.8

Jones, D., Cameron, A., Mason, S., O’Keeffe, C., & Lowe, D. (2017). 6 Prognostic value of the Glasgow Admission Prediction Score: hospital length of stay, mortality and hospital readmission. Emergency Medicine Journal, 34(12), A864.2-A865. doi:10.1136/emermed-2017-207308.6

Ablard, S., Coates, E., Cooper, C., Parry, G., & Mason, S. (2017). Can more appropriate support and services be provided for people who attend the emergency department frequently? National Health Service staff views. Emerg Med J, 34(11), 744-748. doi: 10.1136/emermed-2016-206546

Ablard, S., Rimmer, M., O’Keeffe, C., & Mason, S. (2017). 23 Patient and staff perspectives on the reasons for increasing emergency department attendances. Emergency Medicine Journal, 34(12), A876.2-A876. doi:10.1136/emermed-2017-207308.23

Morris, T., Mason, S. M., Moulton, C., & O’Keeffe, C. (2017). Calculating the proportion of avoidable attendances at UK emergency departments: analysis of the Royal College of Emergency Medicine’s Sentinel Site Survey data. Emergency Medicine Journal. doi:10.1136/emermed-2017-206846

Snooks, H., Anthony, R., Chatters, R., Dale, J., Fothergill, R., Gaze, S., …Mason, S., . . Russell, I. (2017). Paramedic Assessment of Older Adults After Falls, Including Community Care Referral Pathway: Cluster Randomized Trial. Annals of Emergency Medicine, 70(4), 495-505.e28. doi:10.1016/j.annemergmed.2017.01.006

Dickson, J. M., Mason, S. M., & Bailey, A. (2017). Emergency Department Diagnostic Codes – Useful Data?. Emergency Medicine Journal, 34(9), 627. doi:10.1136/emermed-2017-206914

Crede, S., O’Keffee, C., Mason, S., Sutton, A., Howe, E., Croft, S., Whiteside, M. (2017). What is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis. BMC Health Services Research. doi: 10.1186/s12913-017-2299-8

Ablard, S., O'Keeffe, C., Ramlakhan, S., & Mason, S. (2017). Primary care services co-located with Emergency Departments across a UK region: early views on their development. Emergency Medicine Journal. doi:10.1136/emermed-2016-206539

Johnson, M., O’Hara, R., Hirst, E., Weyman, A., Turner, J., Mason, S., Quinn, T., Shewan, J., Siriwardena, N., (2017). Multiple triangulation and collaborative research using qualitative methods to explore decision making in pre-hospital emergency care. BMC Medical Research Methodology. doi: 10.1186/s12874-017-0290-z

Mason, S., Knowles, E., & Boyle, A. (2017). Exit block in emergency departments: a rapid evidence review. Emergency Medicine Journal, 2017;34:46-51. doi: 10.1136/emermed-2015-205201

Martin, G. P., Wright, B., Ahmed, A., Banerjee, J., Mason, S., & Roland, D. (2016). Use or Abuse? A Qualitative Study of Emergency Physicians' Views on Use of Observation Stays at Three Hospitals in the United States and England. Ann Emerg Med. doi:10.1016/j.annemergmed.2016.08.458

Basu, S., Yap, C., & Mason, S. (2016). Examining the sources of occupational stress in an emergency department. Occupational Medicine, 66(9), 737-742. doi:10.1093/occmed/kqw155

Basu, S., Qayyum, H., Mason, S. (2016) Occupational stress in the ED: a systematic literature review. Emerg Med J. 0:1–7. Published Online First: 11 October 2016. doi:10.1136/emermed-2016-205827

O’Keeffe, C., Carter, A., Mason, S. (2016) The value of emergency medicine placements for postgraduate doctors: views of Foundation Year 2 Doctors and training leads in the emergency department (ED). Postgrad Med J. 0:1–5. doi:10.1136/postgradmedj-2016-133973

Ramlakhan, S., Mason, S., O'Keeffe, C., Ramtahal, A., & Ablard, S. (2016). Primary care services located with EDs: a review of effectiveness. Emergency Medicine Journal, 33(7), 496-503. doi:10.1136/emermed-2015-204900

Mason, S., O'Keeffe, C., Carter, A., & Stride, C. (2015). A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements.  Emerg Med J

Abdulwahid, M. A., Booth, A., Kuczawski, M., & Mason, S. M. (2015). The impact of senior doctor assessment at triage on emergency department performance measures: Systematic review and meta-analysis of comparative studies.  Emerg Med J

Koniotou, M., Evans, B. A., Chatters, R., Fothergill, R., Garnsworthy, C., Gaze, S., Halter, M., Mason, S., Peconi, J., Porter, A., Siriwardena, A.N., Toghill, A., Snooks, H. (2015). Involving older people in a multi-centre randomised trial of a complex intervention in pre-hospital emergency care: Implementation of a collaborative model. Trials, 16(1). 

Pickering, A., Harnan, S., Cooper, K., Sutton, A., Mason, S., & Nicholl, J. (2015). Acute ischaemic stroke patients - direct admission to a specialist centre or initial treatment in a local hospital? A systematic review. J Health Serv Res Policy. 

Johnson, R., Kuczawski, M., & Mason, S. (2015). Why is it so difficult to recruit patients to research in emergency care? Lessons from the AHEAD study. Emerg Med J

O'Hara, R., Johnson, M., Siriwardena, A. N., Weyman, A., Turner, J., Shaw, D., Mortimer, P., Newman, C., Hirst, E., Storey, M., Mason, S., Quinn, T., Shewan, J. (2015). A qualitative study of systemic influences on paramedic decision making: care transitions and patient safety. J Health Serv Res Policy, 20(1 Suppl), 45-53. 

Pickering, A., Cooper, K., Harnan, S., Sutton, A., Mason, S., & Nicholl, J. (2015). Impact of prehospital transfer strategies in major trauma and head injury: Systematic review, meta-analysis, and recommendations for study design. Journal of Trauma and Acute Care Surgery, 78(1), 164-177. 

Boyle, A., & Mason, S. (2014). What has the 4-hour access standard achieved? British Journal of Hospital Medicine, 75(11), 620-622. 

O'Hara, R., Johnson, M., Hirst, E., Weyman, A., Shaw, D., Mortimer, P., Newman, C., Storey, M., Turner, J., Mason, S., Quinn, T., Shewan, J., Siriwardena, N. (2014) A qualitative study of decision-making and safety in ambulance service transitions. Health Services and Delivery Research Volume: 2 Issue: 56. December 2014. 

Lecky, F., Benger, J., Mason, S., Cameron, P., & Walsh, C. (2014). The international federation for emergency medicine framework for quality and safety in the emergency department. In Emergency Medicine Journal Vol. 31 (pp. 926-929). BMJ Publishing Group.

Mason, S., Mountain, G., Turner, J., Arain, M., Revue, E., & Weber, E. J. (2014). Innovations to reduce demand and crowding in emergency care; A review study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 22(1), 1-7.

Croft, S. J., Barnes, J., Ginnis, C., Chatters, R., & Mason, S. (2014). An evaluation of the referral process in the emergency department.  Emerg Med J, 31(10), 827-832.

Mason, S. M. (2014). Frequent attendance at the emergency department is a symptom but not a disease. Emergency Medicine Journal31(7), 524-525.

Conroy, S. P., Ansari, K., Williams, M., Laithwaite, E., Teasdale, B., Dawson, J., . . . Banerjee, J. (2014). A controlled evaluation of comprehensive geriatric assessment in the emergency department: The 'Emergency Frailty Unit'. Age and Ageing43(1), 109-114.

O'Keeffe, C., Mason, S., & Knowles, E. (2014). Patient experiences of an extended role in healthcare: comparing emergency care practitioners (ECPs) with usual providers in different emergency and urgent care settings. Emerg Med J, 31(8), 673-674.