Ijtihadi Kamilia Amalina, Tibor Vidákovich
Development and differences in mathematical problem-solving skills: A cross-sectional study of differences in demographic backgrounds
Heliyon
emergency healthcare services intense pressure meet increasing patient demands many patients presenting emergency departments could managed general practitioners general practitioneremergency department service models evaluate effectiveness safety patient experience system implications different general practitioneremergency department models mixedmethods realist evaluation phase 1 20178 understand current practice rapid realist literature review national survey followup key informant interviews national stakeholder event safety data analysis phase 2 201821 collect analyse qualitative observations interviews quantitative data time series analysis costconsequences analysis routine data case site data marker condition analysis purposive sample 13 case sites england wales phase 3 20212 conduct mixedmethods analysis programme theory toolkit development general practitioners commonly work emergency departments delivery models vary widely terms scope general practitioner role scale general practitioner service developed taxonomy describe general practitioneremergency department service models integrated emergency department service parallel within emergency department outside emergency department hospital site present programme theory principal output study describe service models observed operate routine data variable quality limiting analysis time series analysis demonstrated trends across intervention sites increased time spent emergency department increased emergency department attendances reattendances mixed results hospital admissions evidence patient experience limited broadly supportive identified departmentlevel processes optimise safety general practitioneremergency department models quality heterogeneity extent routine emergency department data collection study period limited conclusions recruitment limited criteria case sites time series requirements individual patients marker conditions pandemic pressures limited data collection marker condition analysis data collected analysed pre pandemic new approaches telephone first relevance findings remains unexplored findings suggest general practitioneremergency department service models meet aim reducing overall emergency department waiting times improving patient flow limited evidence cost savings qualitative data indicated general practitioners often valued members wider emergency department team developed toolkit based findings provide guidance implementing delivering general practitioneremergency department services emergency care data set since introduced across england help standardise data collection facilitate research would advocate systematic capture patient experience measures patientreported outcome measures part routine care could done support development general practitioner emergency department role including core set competencies governance structure reflect different general practitioneremergency department models evaluate effectiveness cost effectiveness guide future policy study registered prospero crd42017069741 award funded national institute health care research nihr health social care delivery research programme nihr award ref 1514504 published full health social care delivery research vol 12 10 see nihr funding awards website award information