New research to shed light on how ambulance staff ‘pre-alert’ emergency departments

Researchers from ScHARR at the University of 91ֱ are undertaking a research study with Yorkshire Ambulance Service to understand how ambulance clinicians alert emergency departments that a critically ill patient is on the way.

A yellow emergency ambulance stationed at Emergency Department
Image CC BY 2.0 - Elliott Brown

Pre-alerts are used by ambulance clinicians to inform emergency departments (ED) that a critically ill patient is on the way. Pre-alerts help EDs provide better care, earlier access to time-critical treatment and improved outcomes for patients. However, if pre-alerts are used on the wrong patients or used too often, emergency departments may not be able to respond or stop taking them seriously. The new research will address the need for better evidence in selecting patients for pre-alert in order to improve the process to benefit emergency patient care. 

By observing patterns in existing data, current policies, speaking to staff and patients with their families or carers and watching how pre-alerts happen in real-time, the research team will try to identify how the processes of doing pre-alerts can be improved and identify areas of good practice.

The new study has been funded by a £555,740 grant awarded by the National Institute for Health Research (NIHR) Health Service and Delivery Research Programme and will investigate current pre-alert processes and how these vary between ambulance services and between different types of ambulance staff. The study is also being supported by East Midlands Ambulance Service and West Midlands Ambulance Service University NHS Foundation Trust.

Dr Fiona Sampson, lead author of the research from the University of 91ֱ’s Centre for Urgent and Emergency Care Research (CURE), said: “We are delighted to have been awarded funding to work on this collaborative project, working closely with ambulance and Emergency Department clinicians along with patient and public representatives to understand how ambulance and Emergency Department staff should manage pre-alerts effectively in future”.

, Head of Research at Yorkshire Ambulance Service NHS Trust, said: “This is an example of our amazing ambulance clinicians identifying a real-world evidence gap, and working closely and collaboratively with expert researchers to find the evidence we need. We are looking forward to working with the other research sites to find out how we can further improve the care our emergency patients receive as they transition from ambulance to ED.”

Mark Millins, Lead Paramedic for Clinical Development at Yorkshire Ambulance Service NHS Trust, said: “We are delighted to be taking part in this service driven project that will have a direct impact on improving patient outcomes and experience as well as supporting our crews in deciding which patients should be pre alerted. This study will provide much needed national guidance that will enable crews to make more informed decisions for the benefit of our patients.”

The project’s aim is to produce short, written guidance to ambulance and Emergency Department staff about managing pre-alerts in the future and identify key areas of uncertainty which should be addressed in future national guidance. 

Further information

University of 91ֱ Study Webpage

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