TY - JOUR T1 - Implementing emergency admission risk prediction in general practice: a qualitative study JF - British Journal of General Practice JO - Br J Gen Pract DO - 10.3399/BJGP.2021.0146 SP - BJGP.2021.0146 AU - Bridie Angela Evans AU - Jeremy Dale AU - Jan Davies AU - Hayley Hutchings AU - Mark Rhys Kingston AU - Alison Porter AU - Ian Russell AU - Victoria Williams AU - Helen Snooks Y1 - 2021/08/25 UR - http://bjgp.org/content/early/2021/08/26/BJGP.2021.0146.abstract N2 - Background: Using computer software in general practice to predict patient risk of emergency hospital admission has been widely advocated despite limited evidence about effects. In a trial evaluating introduction of a predictive risk stratification model (PRISM), we reported statistically significant increases in emergency hospital admissions and use of other NHS services without evidence of benefits to patients or the NHS. Aim: to explore experiences of incorporating PRISM into routine practice. Design and setting: semi-structured interviews with 22 general practitioners and practice managers in 18 practices in South Wales. Methods: Interviews at two timepoints: 3-6 months after gaining PRISM access; study end, approximately 18 months later. We analysed data thematically using Normalisation Process Theory. Results: Respondents reported the decision to use PRISM was based mainly on fulfilling reporting requirements for Quality and Outcome Framework (QOF) incentives. Most applied it to a very small number of patients for a short period. Using PRISM entailed technical tasks, information sharing within practice meetings and small-scale changes to patient care. Use was inhibited by PRISM not being integrated with practice systems. Most doubted any large scale impact, but cited examples of impact on individual patient care. They reported increased awareness of patients in high-risk groups. Conclusions: Qualitative results suggest mixed views of predictive risk stratification in general practice and raised awareness of highest-risk patient groups, potentially affecting unplanned hospital attendance and admissions. To inform future policy, decision-makers need more information about implementation and effects of emergency admissions risk stratification tools in primary and community settings. ER -