A dedicated neurologist at the emergency department during out-of-office hours decreases patients’ length of stay and admission percentages
| Autor: | Korné Jellema, Naomi van der Linden, M. Christien van der Linden, Roeline A.Y. de Beaufort, Crispijn L van den Brand, Ido R. van den Wijngaard |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Emergency Medical Services medicine.medical_specialty Time Factors Neurology Adolescent Attitude of Health Personnel Pilot Projects Young Adult 03 medical and health sciences Patient Admission 0302 clinical medicine Surveys and Questionnaires Personnel medicine Humans Neurologists 030212 general & internal medicine Quality of care Qualitative Research Aged Patient Care Team Control period Emergency department business.industry 030208 emergency & critical care medicine Middle Aged Patient flow Cross-Sectional Studies Staffing Emergency medicine Workforce Length of stay Female Neurology (clinical) Nervous System Diseases Emergency Service Hospital business |
| Zdroj: | Journal of Neurology, 265(3), 535-541 |
| ISSN: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-018-8734-x |
| Popis: | Emergency departments (EDs) worldwide face crowding, which hampers patient flow. In this study, the impact of a dedicated neurologist present at the ED on patient flow during out-of-office hours was assessed. A cross-sectional, mixed methods study was undertaken at a Dutch ED, including a pre-post analysis of data of patients who had a primary neurological disease (n = 458) and staff surveys (n = 152). Descriptive statistics and content analysis were used for analyses. Despite a 36% increase in the number of neurological patients (control period: n = 194, intervention period n = 264), a 30 min per patient decrease in ED median length of stay (LOS) was reached during the intervention period. Furthermore, the admission percentage decreased significantly (57.7% in the control period vs. 47.7% in the intervention period, p = 0.03). During half of the shifts neurologists stated that their presence had been valuable. Perceived reasons for this added value mentioned were improved quality of care, enhanced throughput of patients, and quicker consultations with other medical specialists. In our hypothesis-generating study, a dedicated neurologist present at the ED during out-of-office hours was associated with decreased patients’ LOS and a decreased admission percentage, indicating increased decisiveness when the neurologist is present at the ED. |
| Databáze: | OpenAIRE |
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