Air ambulance retrievals of patients with suspected appendicitis and acute abdominal pain: The patients’ journeys, referral pathways and appendectomy outcomes using linked data in Central Queensland, Australia

Edwards, Kristin H.; Edwards, Mark T.; Franklin, Richard C.; Khanna, Sankalp; Kuhnert, Petra M.; Jones, Rhondda

doi:10.1016/j.auec.2022.07.002

Cited by 1 publication

(3 citation statements)

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“…This sequential development design 22 was selected to test the hypothesis of high volume interhospital transfers for suspected appendicitis. Insights gleaned from linked, administrative data outputs, which highlighted frequent ED presentations of suspected appendicitis from rural hospitals within the CQHHS region, 3 validated the findings from the clinician interviews. Authors had prior experience with qualitative research.…”

Section: Methodsmentioning

confidence: 69%

“…Rural and remote Australia has challenges in the provision of emergency health services: increased distance to definitive care centres, increased time intervals from first onset of symptoms to correct diagnosis, potential delays due to weather, decreased access to diagnostic testing, and insufficient health workforce. [1][2][3][4] To strengthen the rural healthcare system, including workforce recruitment, the Australian government has committed $123 million (distributed over 4 years) in the 2021-2022 budget. 5 In a regional 'hub and spoke' referral structure, clinicians in small rural hospitals make decisions to transfer patients to higher levels of care via air ambulance.…”

Section: Introductionmentioning

confidence: 99%

“…Appendicitis was chosen to be studied as a pathology, as it was the most common emergency department (ED) presentation from rural aeromedical transfers within the Central Queensland region. 3 It is the most common emergent surgical procedure performed in the world accounting for approximately 1 million hospital days annually, and the most common differential diagnosis in patients who present with abdominal pain as the leading presentation complaint to Australian emergency departments. 9,17,18 Therefore, appendicitis is a common diagnostic challenge for rural emergency department clinicians.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Requesting air ambulance transport of patients with suspected appendicitis: The decision‐making process through the eyes of the rural clinician

Edwards

Franklin

Edwards³

et al. 2022

Australian J Rural Health

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Objective The primary aim is to explore rural clinicians' self‐reported knowledge, skills and attitudes in the decision‐making process for requesting aeromedical retrieval of patients with suspected appendicitis. A secondary aim is to understand the supports and barriers of rural clinicians experience in this clinical scenario. Setting Clinician interviews conducted face‐to‐face in three rural hospitals in Central Queensland. Participants Rural doctors and nurses. Design A five‐part qualitative content analysis. Results The majority of 44 participants identified the strong and effective teamwork. The decision to request aeromedical retrieval was a shared, joint process and identified a supportive collegial culture which supported the asking of questions and not expecting to have all the answers. Perceived barriers were lack of receiving clinicians understanding of transfer agreements, and data connectivity. Clinician pessimism was identified for perceived patient outcomes. Discussion Effective teamwork can nurture trust and collaboration across multiple health service roles. High job satisfaction may counter the physical isolation in some rural environments. Fragmentation of care is the unintended consequence of interhospital transfer and may impact rural clinicians' perception of patients' outcomes and hinder receiving clinicians' understanding of rural service limitations. Conclusion Future work in the area of linked electronic medical records could remove a barrier for rural clinicians and improve their reflective practice by challenging their perception of definitive patient outcomes. Increased awareness by receiving clinicians of the limitation of rural services, may minimize communication barriers and thereby, improve timely patient care transfers.

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Section: Methodsmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%