The impact of walk-in centres and GP co-operatives on emergency department presentations: A systematic review of the literature

Int Emerg Nurs. 2017 Sep;34:36-42. doi: 10.1016/j.ienj.2017.04.002. Epub 2017 May 12.


Background: Internationally, non-urgent presentations are increasing the pressure on Emergency Department (ED) staff and resources. This systematic review aims to identify the impact of alternative emergency care pathways on ED presentations - specifically GP cooperatives and walk-in clinics.

Methods: Based on a structured PICO enquiry with either walk-in clinic or GP cooperative as the intervention, a search was made for peer-reviewed publications in English, between 2000 and 2014. Medline plus, OVID, PubMed, and Google Scholar were searched. The Critical Appraisal Skills Program (CASP) guidelines were used to assess study quality and data was extracted using an adapted JBI Qualitative Assessment and Review Instrument (QARI). Subsequent reporting followed the PRISMA guideline.

Results: Eleven high quality quantitative studies met the inclusion criteria. Walk-in clinics do have the potential to reduce non-urgent emergency department presentations, however evidence of this effect is low. GP cooperatives offer an alternative care stream for patients presenting to the ED and do significantly reduce local ED attendances. Community members need to be made aware of these options in order to make informed treatment choices.

Conclusion: GP cooperatives in particular do have the potential to reduce ED workload. Further research is required to uncover recent trends and patient outcomes for walk-in clinics and GP cooperatives.

Keywords: Emergency medical services; General practice; Outcome and process evaluation-health care; Physicians primary healthcare; Triage.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Ambulatory Care Facilities / organization & administration
  • Ambulatory Care Facilities / statistics & numerical data*
  • Crowding
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data*
  • General Practice / methods*
  • General Practitioners / statistics & numerical data*
  • General Practitioners / trends
  • Humans
  • Partnership Practice / statistics & numerical data*
  • Partnership Practice / trends
  • Workload / standards