Checklists for emergencies in general practice: Participatory design of a quick reference handbook

Journal article

Background

Emergency presentations in General Practice (GP) are increasing, yet teams may go months without managing one. Cognitive aids such as checklists improve in-hospital emergency care, but existing tools are poorly suited to GP.

Aim

To identify common emergency presentations in GP and co-design bespoke checklists for safer management.

Design & setting

Participatory design of GP-specific emergency checklists and usability testing in real clinical settings with multidisciplinary GP teams.

Method

A multidisciplinary expert group used a mixed-methods participatory methodology to prioritise emergencies and develop checklists for a GP Quick Reference Handbook (GP-QRH). In-situ simulations in 29 GP practices informed iterative refinement of checklist content, layout and usability.

Results

The final GP-QRH comprised 15 clinical emergency checklists, one checklist for non-clinical staff, a structured handover template and emergency debrief guidance. Testing the final version in 11 GP practices was uniformly positive and emphasised the importance of simple design, clear language, prominent prompts for escalation, and team training in checklist use.

Conclusion

We have developed the first QRH for General Practice specifically tailored to primary care, co-designed with intended users. Its impact will depend on commitment to consistent use, local leadership and advocacy across GP networks. Further usability testing, evaluation of clinical impact and development of additional checklists are needed, but the GP-QRH has the potential to enhance emergency care and patient safety in UK general practice and internationally.

Authors: Higham, H; Maloney, A; Greig, PR; Shawcross, E; Harbord, P

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Royal College of General Practitioners
• Journal: British Journal of General Practice Open
• Pages: BJGPO.2025.0268-BJGPO.2025.0268
• Publication date: 2026-01-20
• Acceptance date: 2025-12-22
• DOI: 10.3399/bjgpo.2025.0268
• EISSN: 2398-3795
• ISSN: 2398-3795
• Language: English
• Keywords: Bespoke; Emergency department; Usability; SAFER; Checklist; Patient safety; Debriefing; Participatory design; Multidisciplinary approach