Variations in the patient care process at the emergency department: development
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place:
Geb. 11.40, Raum 253
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sws:
October 25th, 2012
- :October 25th, 2012
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Referent:
Dr. Ir. Maartje Zonderland, University of Twente (Netherlands)
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Zeit:
17:30
Variations in the patient care process at the emergency department: development and implications of an observational instrument
In this talk we discuss the development and implications of an observational instrument,
designed to evaluate treatment routines at an Emergency Department (ED).
The instrument divides all different types of activities a doctor can perform at an
ED into eight categories. In 2010, a pilot study with the instrument was carried
out at the ED of Leiden University Medical Center. All physician activities were
registered on a minute-to-minute base by an independent observer. Ten doctors were
observed during a total of 36 hours in which 42 patients were seen. Although
emergency physicians were observed for a shorter period of time than internists,
they saw more patients. Emergency physicians tended to have more patient contact
time than internists, but both groups dedicated most of their time to documentation
and had little communication with emergency department nurses. The average
LOS of internal patients was significantly higher than for the patients of emergency
physicians. By protocol, patients at the Emergency Department (ED) who are seen
by emergency physicians are treated one by one, resulting in a more or less serial
treatment routine. Physicians from other departments tend to see more patients at
the same time (parallel treatment routine), and thus occupy more treatment rooms
simultaneously. We suspect that the parallel treatment routine is related to a longer
patient LOS and suboptimal ED logistics. In a succeeding study we will mathematically
compare the advantages and disadvantages of serial and parallel treatment
routines at the ED.