Systems for emergency care

Nicholl, Jon

doi:10.1136/bmj.320.7240.955

Cited by 9 publications

(3 citation statements)

References 6 publications

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“…Th e NHS Direct service has been in operation in the UK since 1998. Much of existing scholarship on this service relates to factors such as whether the advice was followed (Foster et al, 2003) whether diff erent computer-aided assessment systems yield diff erent outcomes (O'Cathain et al, 2003) and customer satisfaction (Florin and Rosen, 1999), value for money (George, 2002), or the role it plays in the overall system of care Nicholl and Munro, 2000). However, we know relatively little about the terra incognita of the consultations themselves which take place within it.…”

Section: Background To the Nhs Direct Studymentioning

confidence: 99%

Applying corpus linguistics in a health care context

Adolphs

Brown

Carter

et al. 2004

JALPP

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Th is paper draws on two strands of research and practice in language studies, namely i) studies of communication in health care encounters, and ii) studies of language corpora. It aims to delineate an area of 'applied clinical linguistics' which draws on these existing sub-disciplines so as to enhance our knowledge of communicative events in clinical settings. To illustrate the potential we draw upon a corpus-informed study of communication in staged telephone conversations between callers and advisers in the UK's 'NHS Direct' health advisory service. Here, the combined application of corpus linguistics and conversation analytic techniques has revealed several hitherto undisclosed features concerning strategies used by health advisors to position the caller as the subject of the interaction, give credentials to the advice and terminate the encounter with a 'convergence coda'. Th e integrated approach which combines corpus linguistic methods with existing frameworks in text analysis of health care contexts seems to off er new possibilities of data and theory building, as well as becoming a resource for practitioners themselves in clinical fi eld settings.

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Section: Background To the Nhs Direct Studymentioning

confidence: 99%

Applying corpus linguistics in a health care context

Adolphs

Brown

Carter

et al. 2004

JALPP

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“…However, how the availability of emergency centers (hospital, primary care emergency center) in geographic areas of high population dispersion is related to PCEC use has not been determined. While adequate PCEC access is particularly important in rural areas isolated from urban centers, inadequate utilization of such centers may lead to higher costs, delayed or ineffective response to emergencies, and loss of continuity of care by general practitioners [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the utilization of primary care emergency centers in a Spanish region with high population dispersion: a mixed-methods study

Sanz-Barbero

Otero‐García

Blasco-Hernández

et al. 2014

BMC Health Serv Res

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BackgroundAdequate access to primary care emergency centers is particularly important in rural areas isolated from urban centers. However, variability in utilization of emergency services located in primary care centers among inhabitants of nearby geographical areas is understudied. The objectives of this study are twofold: 1) to analyze the association between the availability of municipal emergency care centers and utilization of primary care emergency centers (PCEC), in a Spanish region with high population dispersion; and 2) to determine healthcare providers’ perceptions regarding PCEC utilization.MethodsA mixed-methods study was conducted. Quantitative phase: multilevel logistic regression modeling using merged data from the 2003 Regional Health Survey of Castile and Leon and the 2001 census data (Spain). Qualitative phase:14 in-depth- interviews of rural-based PCEC providers.ResultsHaving PCEC as the only emergency center in the municipality was directly associated with its utilization (p < 0.001). Healthcare providers perceived that distance to hospital increased PCEC utilization, and distance to PCEC decrease its use. PCEC users were considered to be predominantly workers and students with scheduling conflicts with rural primary care opening hours.ConclusionsThe location of emergency care centers is associated with PCEC utilization. Increasing access to primary care by extending hours may be an important step toward optimal PCEC utilization. Further research would determine whether lower PCEC use by certain groups is associated with disparities in access to care.

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“…Early in its development, much of the research on the service focused on the medical quality of advice delivered and on the economic and health benefits of the service. Factors were investigated such as whether the advice was followed (Foster et al, 2003;Byrne et al 2007), whether the different computer-aided assessment systems yield different outcomes (O'Cathain et al 2003), the quality of the customer satisfaction achieved (Florin and Rosen 1999), value for money (George 2002), or the role NHS direct played in the overall system of care Nicholl and Munro 2000). However, in the early days we knew relatively little about the "terra incognita" of the consultations themselves which took place within it.…”

mentioning

confidence: 99%

Politeness strategies in question formulation in a UK telephone advisory service

Brown¹,

Crawford²

2009

Journal of Politeness Research. Language, Behaviour, Culture

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Politeness is of particular importance in health care contexts, where a number of international agreements and consensus statements formulated by policy makers demand that accord should be maintained, agreement should be solicited, and an attitude of respect be sustained especially when burdensome or intimate matters are being discussed. This paper explores the patterns of politeness in a corpus of material from a UK study of telephone encounters between NHS Direct health advisers and callers presenting with a need for advice over medication. In the opening sequences of interaction the questions that advisers asked the callers often included multiple politeness markers, for example through terms such as "may" and "just", as in "may I just ask you?". Politeness markers were often multiply layered, falling into three part structures which occurred when mundane information such as callers' names and telephone numbers were being elicited. Where more intimate matters were at stake, advisers minimized imposition and, arguably, undertook rapport building by means of preambles to the question such that the impending intrusion is accounted for, explained or mitigated. A potentially problematic question could also be followed up by further relational work and humour. There are important implications here for understanding politeness itself, especially where it is displayed by an institutionally more powerful or symbolically credentialed interactant towards one who is less advantaged.

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Systems for emergency care

Cited by 9 publications

References 6 publications

Applying corpus linguistics in a health care context

Applying corpus linguistics in a health care context

Factors associated with the utilization of primary care emergency centers in a Spanish region with high population dispersion: a mixed-methods study

Politeness strategies in question formulation in a UK telephone advisory service

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