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Background: In primary care, advanced practitioners from nursing and allied health professions are increasingly deployed to assess, diagnose and manage patients. Differential diagnosis decision support systems may assist trainee advanced practitioners with developing their diagnostic decision-making skills. Aim: To identify which differential diagnosis decision support systems are available to primary care clinicians; review the literature regarding these systems; and identify their positive and negative aspects from the perspective of trainee advanced practitioners in primary care. Method: Market research and a literature review were conducted to identify and explore available systems. In an earlier, larger study, focus groups had been conducted with GPs, advanced practitioners and members of the public. The findings from the focus groups are reported here from the perspective of trainee advanced practitioners. Findings: Four commercially available systems were identified – DXplain, Isabel, PEPID and VisualDx – and explored in terms of accuracy, speed and time efficiency, user feedback, use in education, and use in primary care. Focus group participants expressed the views that such systems could guide and confirm diagnostic decisions, but also raised concerns about their potential to stifle decision-making and inhibit critical thinking. Conclusion: In principle, trainee advanced practitioners are open to using differential diagnosis decision support systems, not necessarily to provide them with the knowledge they do not possess but rather to support and reassure them as they adapt to their new roles.

In most emergency departments (EDs), a few patients account for a considerable number of attendances and hospital admissions. Newton and colleagues describe how to reduce these numbers by introducing individual care plans.

Over the past decade, the number of people with cutaneous abscesses who present to emergency departments, walk-in centres or minor injury units has increased.

Emergency department (ED) attendances are, by their nature, unplanned. But if staff can predict the number of people likely to attend over the months ahead, they can make plans to mitigate overcrowding.

There is growing evidence to support the use of mild therapeutic hypothermia (MTH), also known as targeted temperature management, in out-of-hospital patients who have experienced cardiac arrest. Reducing core body temperatures to 32-34°C can reduce mortality and neurological disability significantly among such patients, but recent surveys have shown that use of MTH is variable and there can be a considerable delay in initiating it.

Many patients return to EDs within 28 days of discharge. If staff can recognise the patients who are more likely to re-present, they can offer interventions that reduce the likelihood of them doing so.

In an attempt to reduce haemolysation rates in an Australian ED, Corkill ( 2012 ) placed educational posters in staff toilet cubicles. This novel approach produced a statistically significant reduction in median haemolysis rates, from 4.92 per cent to 3.95 per cent (P=0.001), over a 12-month period.

Researchers analysed data from 55 hospitals in 20 urban areas of the UK during the first wave of the swine flu pandemic between May and September 2009.