An evaluation of our work with local hospital trusts to improve outcomes for ‘high impact users’ of emergency departments (EDs) has been published in the BMJ Open Quality journal.

In England, patients who attend EDs five or more times a year represent 2% of attendees but account for 11% of attendances. These patients are known as high impact users who often experience extremely challenging situations.

The SHarED (Supporting High impact users in Emergency Departments) project, which was named ‘Urgent and Emergency Care Safety Initiative of the Year’ at the 2023 HSJ Patient Safety Awards, supported ED teams to introduce personalised care plans for high impact users. These plans enabled staff to engage with patients about their behaviour and needs and provided recommendations on how to interact with and care for patients. It also promoted collaboration between different specialist teams across the health and care system for more integrated care.

The evaluation of SHarED, conducted by NIHR ARC West, showed it reduced ED attendances by 33% and hospital admissions by 67% among these patients. SHarED successfully promoted better and more integrated care for high impact users and gave practical support to staff working in very difficult environments.

The independent evaluation, ‘Supporting High-impAct useRs in Emergency Departments (SHarED) quality improvement: a mixed-method evaluation’, published in the BMJ Open Quality, also highlighted how SHarED empowered ED staff and showed that the project improved both care for high impact users and the working conditions of staff. Overall, it recommended that Integrated Care Boards should consider funding teams focused on these patients and that rollout of the SHareED model could help establish better services and reduce ED attendance and admissions.

Read more about our SHarED project here.

Posted on January 10, 2024

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