Welcome To The University of Lincoln, College of Social Science Research Blog

University of Lincoln, College of Social Science

Welcome to the University of Lincoln, College of Social Science Research website. This website aims to provide an overview on the wide range of research undertaken within the College of Social Science.  It contains details of events, current studies, community resources and information on how you or your organisation can become engaged with research within the College.

If you are interested in collaborating or discussing potential research ideas with our academics you can visit the Contact Us page.

The effectiveness of primary care streaming in emergency departments on decision-making and patient flow and safety – A realist evaluation

Primary care streaming was implemented in UK Emergency Departments (EDs) to manage an increasing demand for urgent care. We aimed to explore its effectiveness in EDs with different primary care models and identify contexts and mechanisms that influenced outcomes: streaming patients to the most appropriate clinician or service, ED flow and patient safety.

We observed streaming and interviewed ED and primary care staff during case study visits to 10 EDs in England. We used realist methodology, synthesising a middle-range theory with our qualitative data to refine and create a set of theories that explain relationships between contexts, mechanisms and outcomes.

Mechanisms contributing to the effectiveness of primary care streaming were: quality of decision-making, patient flow, redeploying staff, managing patients across streams, the implementation of governance protocols, guidance, training, service evaluation and quality improvement efforts. Experienced nurses and good teamworking and strategic and operational management were key contextual factors.


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