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Emergency Department Crowding

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on 28 April 2014

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Transcript of Emergency Department Crowding

Content
Gemiddelde wachttijd
Tijd tot triage (>5 min)
Gemiddelde doorlooptijd (>4 uur)
Bedbezetting SEH (>100%)
Wachtkamerbezetting SEH
% weglopers (>5%)
Aantal uren ambulanceweigeringen per dag
Wachttijd ambulance tot afleveren (>15 min)
Mening SEH-verpleegkundigen / SEH artsen / SEH managers
% patiënten wachtend op een bed (>10%)
Bedbezetting ziekenhuis
Wachttijd op arts (>30 min voor oranje patiënt)
Aantal ICU-patiënten op de SEH
ED crowding in the Netherlands: nurse managers'
experiences
Self-referring patients at the ED: need for hospital emergency care and motives for self-referral

Unscheduled return visits to a Dutch inner-city ED

Rate, characteristics, and factors associated with high emergency department utilization


Refining a triage system for use in EDs

Managing patient flow with triage streaming to identify patients for Dutch emergency nurse practitioners

Diagnostic accuracy of emergency nurse practitioners versus physicians related to minor illnesses and injuries
Onderzoek
c.van.der.linden@mchaaglanden.nl
Factors influencing flow
Hoe druk is te druk?
Christien van der Linden
Emergency Department Crowding
Crowding occurs when the identified need for emergency services exceeds avaliable resources for patient care in the ED, hospital, or both (ACEP)
Definitie Crowding
Walkouts from the ED: characteristics. reasons and medical care needs

A flexible acute admission unit to decrease length of stay of admitted ED patients: emergency nurses' perceptions.

Evaluation of a flexible acute admission unit: effects on transfers to other hospitals and patients throughput times.
USA: 1993 -2003
Populatie
12% meer

Klinische opname
13% meer

SEH-bezoeken
26% meer
Ziekenhuizen
703 minder

Klinische bedden
198.000 minder

SEH-afdelingen
425 minder
Wens: gestandaardiseerde dataverzameling per instelling
Gevolgen van crowding
*

Langere wachttijden
Langere doorlooptijden
Later pijnstilling
Later antibiotica
Later antistolling
Medicatiefouten
* verwijzingen via mail
Leidend tot
*
:
Ontevredenheid patiënten
Weglopers
Meer complicaties
Ontevredenheid medewerkers
Toename ligduur opnamepatiënten
Hogere kosten i.v.m. overplaatsingen
Verhoogde mortaliteit?
* Verwijzingen via mail
Full transcript