überfüllung der Notaufnahmen

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• 作者：Dr. J. Searle ; R. Muller ; A. Slagman ; C. Sch?fer ; T. Lindner…
• 关键词：Crowding ; überfüllung ; Notaufnahme ; Rettungsstelle ; Kardiales Analogiemodell ; Crowding ; Emergency department ; Emergency medicine ; Emergency services ; Cardiac analogy model
• 刊名：Notfall & Rettungsmedizin
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：18
• 期：4
• 页码：306-315
• 全文大小：495 KB
• 参考文献：1.Ackroyd-Stolarz S, Read GJ, Mackinnon NJ et al (2011) The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study. BMJ Qual Saf 20(7):564-69PubMed View Article
  2.Asbury J-E (1995) Overview of focus group research. Qual Health Res 5:414-420View Article
  3.Babitsch B, Braun T, Borde T et al (2008) Doctor’s perception of doctor-patient relationships in emergency departments: what roles do gender and ethnicity play? BMC Health Serv Res 8:82PubMed Central PubMed View Article
  4.Bender DE, Ewbank D (1994) The focus group as a tool for health research: issues in design and analysis. Health Transit Rev 4(1):63-0PubMed
  5.Beniuk K, Boyle AA, Clarkson PJ (2012) Emergency department crowding: prioritising quantified crowding measures using a Delphi study. Emerg Med J 29(11):868-71PubMed View Article
  6.Bernstein SL, Aronsky D, Duseja R et al (2009) The effect of emergency department crowding on clinically oriented outcomes. Acad Emerg Med 16(1):1-0PubMed View Article
  7.Brachmann M, Geppert R, Niehuis C et al (2014) DGINA (Deutsche Gesellschaft interdisziplin?re Notfall- und Akutmedizin) Positionspapier der AG ?konomie: ?konomische Aspekte der klinischen Notfallversorgung
  8.Epstein SK, Huckins DS, Liu SW et al (2012) Emergency department crowding and risk of preventable medical errors. Intern Emerg Med 7(2):173-80PubMed View Article
  9.Guttmann A, Schull MJ, Vermeulen MJ et al (2011) Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada. BMJ 342:d2983View Article
  10.Higginson I (2012) Emergency department crowding. Emerg Med J 29(6):437-43PubMed View Article
  11.Hoffmann F, Icks A (2012) Structural differences between health insurance funds and their impact on health services research: results from the Bertelsmann Health-Care Monitor. Gesundheitswesen 74(5):291-97PubMed View Article
  12.Krueger R, Casey MA (2008) Focus groups: a practical guide for applied research, 4.?Aufl. SAGE Publications, Thousand Oaks
  13.Meinlschmidt G (Hrsg) (2009) Sozialstrukturatlas von Berlin 2008. Referat Gesundheitsberichterstattung, Epidemiologie, Gemeinsames Krebsregister, Sozialstatistisches Berichtswesen, Gesundheits- und Sozialinformationssysteme
  14.Meinlschmid G (Hrsg) (2014) Handlungsorientierter Sozialstrukturatlas Berlin 2013
  15.Meyer T, Karbach U, Holmberg C et al (2012) Qualitative research in health services research -discussion paper, part 1: what is the idea?. Gesundheitswesen 74(8-):510-15PubMed
  16.Mockel M, Searle J, Muller R et al (2013) Chief complaints in medical emergencies: do they relate to underlying disease and outcome? The Charite Emergency Medicine Study (CHARITEM). Eur J Emerg Med 20(2):103-08PubMed View Article
  17.Mockel M, Searle J, Huttner I et al (2015) Qualitative process analysis and modelling of emergency care workflow and interface management: identification of critical process steps. Eur J Emerg Med 22:79-6PubMed View Article
  18.Pines JM, Pollack CV Jr, Diercks DB et al (2009) The association between emergency department crowding and adverse cardiovascular outcomes in patients with chest pain. Acad Emerg Med 16(7):617-25PubMed View Article
  19.Pines JM, Shofer FS, Isserman JA et al (2010) The effect of emergency department crowding on analgesia in patients with back pain in two hospitals. Acad Emerg Med 17(3):276-83PubMed View Article
  20.Richardson SK, Ardagh M, Gee P (2005) Emergency department overcrowding: the Emergency Department Cardiac Analogy Model (EDCAM). Accid Emerg Nurs 13(1):18-3PubMed View Article
  21.Rondeau KV, Francescutti LH (2005) Emergency department overcrowding: the impact of resource scarcity on physician job satisfaction. J Healthc Manag 50(5):327-40PubMed
  22.Sun BC, Hsia RY, Weiss RE et al (2013) Effect of emergency department crowding on outcomes of admitted patients. Ann Emerg Med 61(6):605-11PubMed Central PubMed View Article
  23.Tekwani KL, Kerem Y, Mistry CD et al (2013) Emergency department crowding is associated with reduced satisfaction scores in patients discharged from the emergency department. West J Emerg Med 14(1):11-5PubMed Central PubMed View Article
  
• 作者单位：Dr. J. Searle (1)
  R. Muller (2)
  A. Slagman (1) (4)
  C. Sch?fer (3)
  T. Lindner (1)
  R. Somasundaram (5)
  U. Frei (6)
  M. M?ckel (1) (4)
  
  1. Arbeitsbereich Notfallmedizin/Rettungsstellen Campi-Nord, Campus Virchow Klinikum und Campus Charité Mitte, Charité ?Universit?tsmedizin, Augustenburger Platz 1, 13353, Berlin, Deutschland
  2. Faculty of Medicine, Health & Molecular Sciences, School of Public Health, Tropical Medicine & Rehabilitation Sciences, James Cook University, Tropical Health Solutions Pty Ltd, Townsville, Australien
  4. Medizinische Klinik mit Schwerpunkt Kardiologie, Campus Virchow Klinikum, Charité -Universit?tsmedizin, Berlin, Deutschland
  3. Gesch?ftsbereich Unternehmenscontrolling -Klinikumscontrolling, Charité ?Universit?tsmedizin, Berlin, Deutschland
  5. Rettungsstelle Campus Benjamin Franklin, Charité -Universit?tsmedizin, Berlin, Deutschland
  6. Charité ?Universit?tsmedizin, Berlin, Deutschland
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Emergency Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1436-0578

文摘

Background Emergency departments (ED) in Germany report increasing levels of crowding, which have a negative impact on ED processes. Aims The purpose of this study is to evaluate perceived reasons for ED crowding as well as population-based influencing factors and to develop a database for further research and solution strategies. Methods This is a mixed methods study conducted at two university EDs with sociodemographically different catchment areas (ED North, population with a lower socioeconomic status, ED South, population with a higher socioeconomic status), comprising a descriptive secondary data analysis of 34,333?ED patients and qualitative focus group interviews with medical staff of these EDs. Results Although patients were older and more often hospitalized in ED South, morbidity and in-hospital mortality of admitted patients was higher in ED North. Perceived reasons were similar in both institutions with mainly external and patient-related factors causing high patient volumes and a slow outflow of patients. There were marked differences in the key areas of discussion, which can be comprehended on the basis of the patient data. Staff in both EDs reported a perceived high level of “protective medicine-as causing ED crowding. Discussion Perceived reasons for ED crowding are mainly found outside the influence of the EDs and are affected by their patient population. Solution strategies have to reach beyond process-optimization strategies in the EDs themselves and should intervene at population and social/health care system levels.