Exploring the use of pre-hospital pre-alerts and their impact on patients, ambulance service and emergency department staff: a mixed-methods study

Sampson FC, Long J, Coster J, O’Hara R, Pilbery R, Bell F, Goodacre S, Boyd A, Webster P, Herbert E, Foster A, Spaight R, Rosser A, Millins M, Pountney A, Miles J, Turner J
Record ID 32018015194
English
Authors' objectives: Ambulance clinicians use pre-alert calls to emergency departments to enable them to prepare for the arrival of a patient. This can lead to improved time-critical treatment. However, pre-alerts should be used judiciously, as over-alerting may add pressures on busy emergency departments, while under-alerting may lead to delays in time-critical patient care. We undertook a mixed-methods study to explore how pre-alerts are used and their impact on patients, ambulance and emergency department staff.
Authors' methods: The mixed-methods study integrated data from: (1) linked routine data set of 12 months’ (2020–1) electronic patient records (3 ambulance services), clinician information and routine hospital statistics, (2) semistructured interviews with 34 ambulance clinicians and 40 emergency department staff and 162 hours non-participant observation of pre-alerts across 6 emergency departments, (3) national online survey of ambulance clinicians (1298 responses). Multivariate logistic regression was undertaken in R™ (The R Foundation for Statistical Computing, Vienna, Austria) to identify factors associated with pre-alert rates in terms of patient (National Early Warning Score 2, working diagnosis, age, sex), ambulance clinician (experience, role, sex, time to end of shift) and hospital factors (journey time, percentage of ambulances waiting > 30 minutes). Qualitative data were analysed using thematic analysis in NVivo™ (QSR International, Warrington, UK). Findings were integrated using a triangulation protocol. Despite flexible recruitment procedures, no patients were interviewed.
Details
Project Status: Completed
URL for project: https://www.journalslibrary.nihr.ac.uk/programmes/hsdr/NIHR135979
Year Published: 2026
URL for published report: https://www.journalslibrary.nihr.ac.uk/hsdr/GJFS4321
URL for additional information: English
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: England, United Kingdom
DOI: 10.3310/GJFS4321
MeSH Terms
  • Emergency Medical Services
  • Emergency Service, Hospital
  • Ambulances
  • Emergency Medical Service Communication Systems
Contact
Organisation Name: NIHR Health Services and Delivery Research programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
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