Urgent care: a need for change ?

1. Identification Records identified through database searching (n=2369) Additional records identified through other searching (n= N/A) Results Our results show that out of our 13 papers included for analysis, 9 showed that urgent care had a positive effect on reducing ED visits. Urgent care comprised WICs, GPOOH clinics, Emergency care practicioners, Nurse-led referral to GPs, an acute medical assessment unit with a call center and an MIU. GP urgent care services(out of hours and referral to GP) was shown to have an overall positive outcome. DM Tong, TLF Lam, Dr JD Fisher Warwick Medical School Records after duplicates removed (n=2369) Screening Titles and abstracts screened (n=2369) Records excluded (n=2219) Eligibility Urgent care: a need for change? Articles excluded with reason (n=137) Articles assessed for eligibility (n=150) Included Studies included for analysis (n=13) Figure 3. Number of studies in respective urgent care categories Research Question Is the current implementation of urgent care via UCCs, WiCs and MIUs an effective measure to reduce Emergency Department demand? Figure 4. Analysis of studies that reflecting changes in Emergency department admissions Discussion The accumulated data shows that urgent care has an overall positive effect on emergency department presentations. The majority of these are due to GP urgent care provision. Comparison between different urgent care provision show that urgent care could reduce ED visits by: Directly reducing ED presentations or re-attendance Decreasing referrals Increasing patient satisfaction Decreasing ED wait times Decreasing cost Methods Medline search with identified key terms Screening via PRISMA template Collection of data using evidence-based table Analysis of results to generate meaningful conclusion and suggestion for current policy Introduction A number of centres for the delivery of unscheduled urgent care in the community, for example, urgent care centres(UCC), walk-in-centres(WiC), and minor injury units(MIU), have been introduced in some areas of the United Kingdom. The aim of these initiatives is to reduce the demand on emergency departments. However, their development has been unsystematic, with no specific remit for operation, or approach for evaluation. This evidence synthesis is designed to identify models of urgent care and evaluate their impact in reducing emergency department demand. Conclusions In conclusion, the overall effect of urgent care on emergency department presentations is positive. GP services are efficacious but evidence is not as clear in other forms of urgent care; further studies are warranted. Figure 2. Hierarchy of evidence Acknowledgements and References We thank Dr. Fisher for her support, input and mentoring throughout the project. We thank URSS for the generous support for the research. Figure 1. PRISMA template, screening and including only relevant studies