[Implementing a strategy to manage frequent emergency room visits in a district of Barcelona].

Autor:	Giménez E; Grup de Recerca en Serveis Sanitaris, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, España; Sistemas de Información y Apoyo a la Decisión, Hospital Universitari Vall d'Hebron, Barcelona, España. Electronic address: enmanuel.gimenez@vallhebron.cat., Abadías MJ; Grup de Recerca en Serveis Sanitaris, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, España., San-José A; Servicio de Medicina Interna, Hospital Universitari Vall d'Hebron, Barcelona, España., Losada M; Enfermera, Área de Conocimiento de Alternativas a la Hospitalización, Servicio de Geriatría, Hospital Universitari Vall d'Hebron, Barcelona, España., Acezat J; Equipo de Atención Primaria de Casernes, Institut Català de la Salut, Barcelona, España., Ibáñez J; Hospital de Día, Medicina Interna, Departamento Asistencial, Hospital San Rafael, Barcelona, España., Marte L; Grup de Recerca en Serveis Sanitaris, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, España., Barrecheguren M; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, España., Méndez AB; Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, España., Aguayo-Álvarez M; Grup de Recerca en Serveis Sanitaris, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, España; Departamento de Calidad, Procesos e Innovación, Vall d'Hebron Institut de Recerca, Barcelona, España., Arranz M; Servicio de Urgencias, Hospital Universitari Vall d'Hebron, Barcelona, España., Ramos R; Grup de Recerca en Serveis Sanitaris, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Barcelona, España; Sistemas de Información y Apoyo a la Decisión, Hospital Universitari Vall d'Hebron, Barcelona, España.
Jazyk:	Spanish; Castilian
Zdroj:	Gaceta sanitaria [Gac Sanit] 2024 Nov 19; Vol. 38, pp. 102428. Date of Electronic Publication: 2024 Nov 19.
DOI:	10.1016/j.gaceta.2024.102428
Abstrakt:	Visits to hospital emergency departments by patients with multimorbidity, complex chronic conditions, and frailty are becoming an increasing challenge. A territorial strategy has been developed, based on automated preselection lists, a nurse case manager with specialized experience, and a multi-level territorial referral consensus. The feasibility of this approach has been demonstrated, with 368 alerts detected, 85% of which were well-selected. Age, frailty, home care percentage, Barthel index, and cognition were progressively aligned with levels of care/referral (primary, intermediate, and specialized) according to previously agreed criteria. In 2024, there is extensive structured technical information, an expanding role for advanced nursing, and well-established inter-level service resources. Therefore, through automated selection, a consensual territorial protocol of pathways and clinical profiles, and autonomous nursing assessments managing multi-frequent cases, it would be possible to achieve, in a proactive, simple, and scalable manner, an appropriate distribution of alerts across levels, consistent with the social and healthcare needs of the patients. (Copyright © 2024. Publicado por Elsevier España, S.L.U.)
Databáze:	MEDLINE
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