Janette Turner

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AIM This paper is a report of the synthesis of evidence on the appropriateness of, and compliance with, telephone triage decisions. BACKGROUND Telephone triage plays an important role in managing demand for health care. Important questions are whether triage decisions are appropriate and patients comply with them. DATA SOURCES CINAHL, Cochrane Clinical(More)
BACKGROUND Some emergency admissions can be avoided if acute exacerbations of health problems are managed by the range of health services providing emergency and urgent care. AIM To identify system-wide factors explaining variation in age sex adjusted admission rates for conditions rich in avoidable admissions. DESIGN National ecological study. (More)
OBJECTIVES To investigate the relationship between case volume and outcome for major trauma patients. METHODS Prospective follow-up study of all major trauma patients (with injury severity score >15) arriving alive, with no invariably fatal injury, at 14 English emergency departments between 1990 and 1993. Using the stratified W statistic, an age and(More)
OBJECTIVES Paramedics routinely make critical decisions about the most appropriate care to deliver in a complex system characterized by significant variation in patient case-mix, care pathways and linked service providers. There has been little research carried out in the ambulance service to identify areas of risk associated with decisions about patient(More)
OBJECTIVES Reconfiguration of emergency services could lead to patients with life-threatening conditions travelling longer distances to hospital. Concerns have been raised that this could increase the risk of death. We aimed to determine whether distance to hospital was associated with mortality in patients with life-threatening emergencies. METHODS We(More)
OBJECTIVES To evaluate the role of ambulance response times in improving survival for out-of-hospital cardiac arrest (OHCA). METHODS OHCAs were identified by sampling consecutive life-threatening category A emergency ambulance calls on an annual basis for the 5 years 1996/7-2000/1 from four ambulance services in England. From these, all calls where an(More)
OBJECTIVE To determine the most effective cut-off of TRISS-derived probability of survival (TRISS-PS) for the selection of trauma deaths for audit, using a large sample of trauma deaths from the United Kingdom (UK). METHODS TRISS-PS and avoidability of death (as judged by an independent peer review panel) were compared for a sample of 222 trauma deaths.(More)
OBJECTIVE To identify factors affecting variation in avoidable emergency admissions that are not usually identified in statistical regression. METHODS As part of an ethnographic residual analysis, we compared six emergency and urgent care systems in England, interviewing 82 commissioners and providers of key emergency and urgent care services. RESULTS(More)
BACKGROUND In 2010, a new telephone service, NHS 111, was piloted to improve access to urgent care in England. A unique feature is the use of non-clinical call takers who triage calls with computerized decision support and have access to clinical advisors when necessary. Aim. To explore users' acceptability of NHS 111. DESIGN Cross-sectional postal(More)
Emergency Department demand continues to rise in almost all high-income countries, including those with universal coverage and a strong primary care network. Many of these countries have been experimenting with innovative methods to stem demand for acute care, while at the same time providing much needed services that can prevent Emergency Department(More)