Prudent healthcare in emergency departments: a case study in Wales
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Prudent healthcare in emergency departments: a case study in Wales

Louise Condon Professor, College of Human and Health Sciences, Swansea University and Abertawe Bro Morgannwg University Health Board, Wales
Sharon Burford Project manager, Llanelli Wellness and Life Science Village, Carmarthenshire County Council, Wales
Robin Ghosal Consultant respiratory physician and hospital director, Prince Philip Hospital, Llanelli, Wales
Brett Denning General manager, Prince Philip Hospital, Llanelli, Wales
Gail Rees Emergency nurse practitioner and senior sister, Minor injuries unit, Prince Philip Hospital, Llanelli, Wales

To deliver a patient-centred service, emergency departments (EDs) must be efficient, effective and meet the needs of the local population. This article describes a service redesign of unscheduled care in a hospital in Wales, which followed the principles of prudent healthcare to improve patient experiences. Extending the roles of nurse specialist practitioners was a major component of the redesign. Six working groups were established to guide the process, one of which was responsible for working cooperatively with the local community, which was concerned about perceived ‘downgrading’ of the ED. The service redesign was completed in 2016 and evaluation shows the target for patients being seen in under four hours improved from 88% to 96%, significantly more acute medical admission patients were discharged in less than 24 hours, and patient satisfaction increased overall.


Emergency Nurse. 25, 10,20-23. doi: 10.7748/en.2018.e1762

Received: 04 August 2017

Accepted: 31 October 2017

Published in print: 09 March 2018

Conflict Of Interest

None declared

Peer review

This article has been subject to external double-blind review and has been checked for plagiarism using automated software