TY - JOUR
T1 - STRategies to manage Emergency ambulance Telephone Callers with sustained High needs: an Evaluation using linked Data (STRETCHED) – a study protocol
AU - Aslam, Rabeea'h W
AU - Snooks, Helen
AU - Porter, Alison
AU - Khanom, Ashrafunnesa
AU - Cole, Robert
AU - Edwards, Adrian
AU - Edwards, Bethan
AU - Evans, Bridie Angela
AU - Foster, Theresa
AU - Fothergill, Rachael
AU - Gripper, Penny
AU - John, Ann
AU - Petterson, Robin
AU - Rosser, Andy
AU - Tee, Anna
AU - Sewell, Bernadette
AU - Hughes, Heather
AU - Phillips, Ceri
AU - Rees, Nigel
AU - Scott, Jason
AU - Watkins, Alan
N1 - Funding information: This project is funded by the National Institute for Health Research (NIHR) Health Services & Delivery Research (HS&DR) Programme (reference 18/03/02). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
PY - 2022/3/29
Y1 - 2022/3/29
N2 - Introduction: UK ambulance services have identified a concern with high users of the 999 service and have set up ‘frequent callers’ services, ranging from within-service management to cross-sectoral multidisciplinary case management approaches. There is little evidence about how to address the needs of this patient group. Aim: To evaluate effectiveness, safety and efficiency of case management approaches to the care of people who frequently call the emergency ambulance service, and gain an understanding of barriers and facilitators to implementation. Objectives: (1) Develop an understanding of predicted mechanisms of change to underpin evaluation. (2) Describe epidemiology of sustained high users of 999 services. (3) Evaluate case management approaches to the care of people who call the 999 ambulance service frequently in terms of: (i) Further emergency contacts (999, emergency department, emergency admissions to hospital) (ii) Effects on other services (iii) Adverse events (deaths, injuries, serious medical emergencies and police arrests) (iv) Costs of intervention and care (v) Patient experience of care. (4) Identify challenges and opportunities associated with using case management models, including features associated with success, and develop theories about how case management works in this population. Methods and analysis: We will conduct a multisite mixed-methods evaluation of case management for people who use ambulance services frequently by using anonymised linked routine data outcomes in a ‘natural experiment’ cohort design, in four regional ambulance services. We will conduct interviews and focus groups with service users, commissioners and emergency and non-acute care providers. The planned start and end dates of the study are 1 April 2019 and 1 September 2022, respectively Ethics and dissemination: The study received approval from the UK Health Research Authority (Confidentiality Advisory Group reference number: 19/CAG/0195; research ethics committee reference number: 19/WA/0216). We will collate feedback from our Lived Experience Advisory Panel, the Frequent Caller National Network and Research Management Group for targeted dissemination activities.
AB - Introduction: UK ambulance services have identified a concern with high users of the 999 service and have set up ‘frequent callers’ services, ranging from within-service management to cross-sectoral multidisciplinary case management approaches. There is little evidence about how to address the needs of this patient group. Aim: To evaluate effectiveness, safety and efficiency of case management approaches to the care of people who frequently call the emergency ambulance service, and gain an understanding of barriers and facilitators to implementation. Objectives: (1) Develop an understanding of predicted mechanisms of change to underpin evaluation. (2) Describe epidemiology of sustained high users of 999 services. (3) Evaluate case management approaches to the care of people who call the 999 ambulance service frequently in terms of: (i) Further emergency contacts (999, emergency department, emergency admissions to hospital) (ii) Effects on other services (iii) Adverse events (deaths, injuries, serious medical emergencies and police arrests) (iv) Costs of intervention and care (v) Patient experience of care. (4) Identify challenges and opportunities associated with using case management models, including features associated with success, and develop theories about how case management works in this population. Methods and analysis: We will conduct a multisite mixed-methods evaluation of case management for people who use ambulance services frequently by using anonymised linked routine data outcomes in a ‘natural experiment’ cohort design, in four regional ambulance services. We will conduct interviews and focus groups with service users, commissioners and emergency and non-acute care providers. The planned start and end dates of the study are 1 April 2019 and 1 September 2022, respectively Ethics and dissemination: The study received approval from the UK Health Research Authority (Confidentiality Advisory Group reference number: 19/CAG/0195; research ethics committee reference number: 19/WA/0216). We will collate feedback from our Lived Experience Advisory Panel, the Frequent Caller National Network and Research Management Group for targeted dissemination activities.
KW - accident & emergency medicine
KW - chronic airways disease
KW - diabetes & endocrinology
KW - epilepsy
KW - health services administration & management
KW - mental health
UR - http://www.scopus.com/inward/record.url?scp=85127298901&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-053123
DO - 10.1136/bmjopen-2021-053123
M3 - Article
SN - 2044-6055
VL - 12
SP - 1
EP - 9
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e053123
ER -