If people think they need medical attention or advice, they have to decide whether they go to their GP, to A&E or to another healthcare service.
Their decision about which service they should go to, and when, can be influenced by a number of factors, including how urgently they need attention, the nature of their problem or how close they are to the location of a certain healthcare provider. However, many people’s default choice is to visit A&E and this can result in overcrowding and longer waiting times that can leave visitors feeling stressed, which may make them more likely to behave aggressively.
By working with designers, healthcare providers can share the information people need in order to decide which is the most appropriate healthcare service for them to access, and they can help manage expectations about a visit to A&E by providing details on waiting times and services provided.
NHS Direct has been designed to help people make an informed decision and then find out where they can find their nearest relevant healthcare provider. It acts as a fast-track system to direct minor-injuries patients to the most suitable treatment for them. It is delivered online, but crucially also has a telephone hotline which is open 24 hours a day, 365 days a year.
The ChooseWell campaign, created by Knowsley Primary Care Trust (PCT) in partnership with NHS Direct, but now supported across the UK, aims to reduce the burden on all in-demand NHS services by helping people to associate the severity of their symptoms with a particular NHS service:
- A&E or 999 — for critical or life-threatening situations
- NHS Walk-in Centre — for treatment of minor illnesses or injuries, without an appointment
- GP — for medical advice, examinations and prescriptions for illnesses you just can’t shake off
- Pharmacist — for advice on common winter illnesses, and the best medicines to treat them
- NHS Direct — for absolutely any health questions, around the clock, and to find local services
- Self-care — for treatment of minor winter illnesses, by combining a well stocked medicine cabinet with plenty of rest
A set of campaign resources has been designed to help spread the message and videos are a key part of the campaign:
Local NHS Trusts, such as NHS North West, have created their own viral videos to spread the message about when to go to A&E.
The United Lincolnshire Hospitals NHS Trust has recognised that visitors understanding of current demand levels in A&E will impact upon their overall satisfaction with the service. It designed a new way for its A&E departments to communicate with patients before they arrive at A&E. Webcams positioned in the waiting areas stream real-time information onto the Trust website, so potential can check out how busy the departments are before deciding to visit. [Reference: United Lincolnshire Hospitals NHS Trust, Live waiting times, 2010]
“The many causes of overcrowding have had a negative effect on physician productivity. Emergency physicians have attempted to fill in the gaps, as they must stretch their ability to see many patients at the same time. At a certain limit of patients, productivity declines and patient care is compromised.” [Reference: Derlet and Richards, 2000].
Often, A&E is not the only place patients can receive the diagnosis, advice and treatment they require. NHS Direct can help visitors decide to use alternative treatment facilities that are available, but this advice is not necessarily tailored to local situations. So, NHS Bristol launched its own iPhone app to provide local patients with information on local health services and how they could access them. The app gives GPS directions and sends reminders about GP appointments in a bid to cut down on the number – and cost – of missed meetings. [Reference: www.managementinpractice.com]
Read on
Use the links below to find out more about the triggers of violence and aggression at other stages of the patient's journey through A&E and how procuring design can help make A&E safer for staff and patients