What information is required in a preliminary clinical evaluation? A service evaluation

Abstract

Introduction: The preliminary clinical evaluation (PCE) abnormality flagging system is a progression from the red dot system. The need for a PCE service may be reduced by immediate "hot" reporting services, however, PCE can be valuable in those Trusts that do not have a "hot reporting"service, as well as in the out of hours setting. This study aimed to identify what information clinicians require within the PCE to aid decision making.

Methods: Emergency Department (ED) clinicians and Radiology reporters were approached to complete a paper survey seeking their preferences on various aspects of the What, Where, How model, regarding their usefulness. Questions were a combination of multiple choice, Likert scale, and free-text.

Results: Thirty participants (20 ED clinicians and 10 Radiology Reporters) provided a 100% response rate. Overall, Where was considered to be most significant (n = 18, 60%), followed by What (n = 11, 37%). Half of participants (n = 15, 50%) considered How to be least significant. ED clinicians found all aspects of the What, Where, How useful, in particular the Where, but to a slightly lesser extent regarding how much displacement was involved. Overall, the information ranked as least useful was how much movement, followed by direction of movement, and type of fracture. The preferred style for a PCE comment is a bullet format.

Conclusion: PCE content should accommodate the preferences of ED referrers. Our findings suggest clinicians want information pertaining to what the abnormality is (i.e. the type of injury), where it was (more specific than simply which bone) and if displacement is present.

Implications for practice: These findings add to the current knowledge base and provide support to the local department when implementing the PCE system.