An evaluation of early pregnancy outcomes in one Australian Emergency Department: Part 2

SummaryBackgroundMore than one in five pregnancies ends in miscarriage. Women experiencing complications associated with early pregnancy often present to the Emergency Department (ED). In 2005, an Early Pregnancy Assessment Clinic (EPAC) was implemented in one Australian ED to specifically address acute needs of women with complications of early pregnancy.MethodsThis mixed methods study incorporated two parts: Part 1 utilised content analysis of semi-structured interviews conducted with health care professionals and EPAC women to evaluate the EPAC structures and processes. Part 2 was an observational study describing characteristics and temporal trends of ED presentations involving problems of early pregnancy over a 6-year period (2004–2009). Results from Part 2 are presented in this paper; findings from Part 1 are presented in a previous paper.ResultsOver the 6-year period 4958 presentations were made to the ED from women with complications of early pregnancy. Outcomes that improved over time included: time to see a clinician, ED length of stay, hospital admission rate and the number of pathology tests ordered per presentation. These outcomes were particularly noted to improve following the implementation of the EPAC.ConclusionsChanges to service delivery for a select patient group (in this case women presenting to the ED with complications during early pregnancy) can impact positively on patient and service provider outcomes.