Pathways to the Accidents and Emergency Department Report of a Study of the Use by Patient of an Accident and Emergency Department

This study had the aim of exploring the various pathways followed by patients attending an accident and emergency department and the reasons why these pathways were taken.

The major focus of the study was to examine the empirical validity of the propositions developed by the Casualty Surgeons' Association (1973).

The suggestion in these propositions is that the won< of the Accident and Emergency departments should consist of the provision of medical services in emergency situations. They argue that emerrencies should be defined in social rather than clinical terms. Patients whose choices of alternative sources of medical care are limited by their social predicament might be seen by the C.S.A. as legitimate attenders at the accident and emergency

department. In that the accident and emergency department is seen to be providing a 'community' emergency service then social predicaments are defined in terms of predicaments that occur in community settings.

Predicaments are episodes which take place in the community and which lead to injury or ill health and disrupt the 'normal' flow of daily activities in public life. The major aim should be to restore these activities back

to their normal flow, and the patient is taken to the accident and emergency department and the predicament is resolved .