Paramedic PapersHome Operations & systems Co-design of urine culture stewardship in ED
Operations & systems
Co-design of urine culture stewardship in ED
Co‐Design of a Theory‐Informed, Multicomponent, Intervention for Diagnostic Stewardship in a Major‐Referral Emergency Department: A Qualitative Descriptive Study
Emergency Medicine Australasia · Added 29 September 2026
Qualitative co-design study at Townsville ED (7 workshops, 35 emergency physicians) building a theory-informed intervention against low-value urine cultures — culture, complexity and efficiency drove over-ordering, with education, nudges, clinical champions and audit/feedback chosen as the fix.
- Study type
- Qualitative
- Design
- Qualitative descriptive study using co-design workshops
- Participants
- 35 emergency physicians across 7 workshops
- Main finding
- Culture, complexity and efficiency drove low-value urine cultures; education, nudges, clinical champions and audit/feedback were selected as intervention components, with workflow inefficiency and credibility of change seen as challenges.
- Caveat
- Single ED, qualitative design; no effect or outcome data.
- Bottom line
- Context only
Why it matters in Australia (Medium relevance). transferability — ED pathology ordering rather than prehospital practice; the transferable part is the co-design-plus-behavioural-theory method for ambulance QI work
Learning goal
Understand how workplace culture and workflow pressures drive low-value pathology ordering in my practice.
More
- Topic: Operations & systems
- Daily scan: 29 September 2026
- Podcast: Paramedic Papers Daily, 29 September 2026
Related papers on Operations & systems
-
Risk-score-guided conveyance safe in chest pain
A Dutch pragmatic RCT testing whether a prehospital risk score could guide ambulance conveyance in 5170 adults with undifferentiated chest pain — it was non-inferior to usual care for 3-day serious adverse events while increasing non-conveyance, cutting 30-day ED presentations and lowering costs.
-
What paramedics want from voice-to-text ePCRs
A mixed-methods survey of 323 Canadian paramedics plus 14 interviews identified and ranked the features paramedics want in speech-recognition documentation — 86% viewed it positively, with accuracy, patient interaction and compliance rated most important.
-
GPS beats app taps for measuring responder arrival
An observational study of 1,498 smartphone first-responder alerts in Germany found GPS geofence entry (50 m) gave more reliable and earlier arrival times (median 4 min 40 s) than manual app confirmation (median 5 min 50 s, often delayed or missing).
-
Checklists may speed time-critical transfers
A UK HEMS service evaluation found introducing referring-hospital and transport-team checklists for time-critical interhospital helicopter transfers improved achievement of a sub-45-minute turnaround KPI from 52% to 64%, though not significantly.