Access block and emergency department overcrowding

Forero, Roberto; McCarthy, Sally; Hillman, Ken

doi:10.1186/cc9998

Cited by 162 publications

(122 citation statements)

References 35 publications

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“…Auch werden durch den Betrieb von Notaufnahmen z. B. in neurologische Abteilungen schwerer betroffene Patienten mit höhe-rem Versorgungsaufwand selektioniert, der nicht immer in den DRG-Erlösen abgebildet ist [20,27]. …”

Section: Notfallgeneralist Vs Neurologische Notfallkompetenzunclassified

Brennpunkt Notaufnahme

2016

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The number of patients treated in hospital emergency departments in Germany has risen in recent years to approximately 20 million. This escalation also applies to the increasing numbers of patients presenting with neurological symptoms and diseases, which occur in approximately 20 % of emergency patients. In addition to patients with stroke, inflammatory or degenerative central nervous system (CNS) and peripheral nervous system (PNS) disorders who need urgent treatment, more and more patients with nonspecific complaints or conditions attend emergency departments for elective treatment, not least because timely appointments with specialist neurologists in practices could not be obtained. Neurological expertise and presence in emergency departments at the level of specialist standard are therefore indispensable for providing a professional level of treatment, which also corresponds to current legal requirements. The implementation of a generalist emergency physician in Germany, as introduced in some European countries, would mean a retrograde step for neurological expertise in emergency admission management. The discipline of neurology must work together with other emergency disciplines to improve the financing of emergency departments and provide neurologists working there with a substantive curriculum of further and continuing education in emergency-related aspects of neurology. The discipline of neurology has a responsibility to emergency patients within its range of competencies and must, therefore, strengthen and improve its role in healthcare politics and concerning organizational and personnel aspects of neurological emergencies.

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Section: Notfallgeneralist Vs Neurologische Notfallkompetenzunclassified

Brennpunkt Notaufnahme

2016

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“…Este hacinamiento es generalmente aceptado como una razón para la disminución de la efi ciencia y la calidad de la atención, y también se ha relacionado con una mayor incidencia de eventos adversos (3) . El hacinamiento no solo se asocia con peores resultados en los pacientes, sino que también contribuye a la demanda perdida para los servicios de urgencias cuando los pacientes salen sin ser vistos y los hospitales deben conti nuar con desviar las ambulancias (4) .…”

Section: Revisión Del Problema En Publicaciones Médicas Internacionalesunclassified

Hacinamiento en los servicios de emergencia

Varillas

2017

An Fac med

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Existe hacinamiento de pacientes en los servicios de emergencia de nuestros hospitales públicos; sin embargo, se trata de un problema presente en otros países, cuya mención aparece en la literatura médica foránea como crowding. Se presenta una breve revisión de la literatura médica que trata su aparición en el tiempo. Se exponen causas, consecuencias y alternativas de solución. Ante la carencia de trabajos de investigación nacionales, se tomó como fuente informes de Contraloría General de la República sobre implementación y cumplimiento de las normas técnicas en áreas críticas de 8 hospitales públicos de Lima y Callao el año 2012. Se analizó el informe de Defensoría del Pueblo, inspección de 149 hospitales a nivel nacional el mismo año. Se describe las brechas presentes entre las ofertas de cama y sobredemanda de atenciones en los servicios de emergencia inspeccionados, así como las condiciones en que permanecen los pacientes y trabaja el personal de salud en los servicios de emergencia. Se expone otras situaciones que comprometen el acceso y la atención oportuna de personas que demandan ser atendidos. Se resume las recomendaciones presentadas por ambos entes inspectores en torno a la congestión de pacientes dentro de los servicios de emergencia. El hacinamiento es un grave problema de salud pública. Los principales prestadores públicos de salud tienen que priorizar la realización de estudios al respecto y proponer soluciones, con planes de desarrollo y mejora progresiva en el corto y mediano plazo.

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“…Moreover, a variety of interesting consensus documents recommending how to improve patient flow have also been published [54][55][56][57][58] . However, evidence-based experiences testing these strategies are still very limited to date [15,16] , being the uniform conclusion of most of them that it's all about to increase the number of available inpatient beds, while waiting for system-wide solutions [23,[59][60][61] .…”

Section: Discussionmentioning

confidence: 99%

“…Far from being resolved, systematic pressures in health care such as seasonal demands, hospital restructuring, or waiting lists for elective surgery, have led hospitals to a sustained competing bed demand between emergency and scheduled patients for hospital admission [4][5][6][7][8][9][10] . Hospitalist physicians and the emergency departments (ED) regard the inability for managing this dysfunctional "competition" with enormous concern as they are presented daily with "boarded" patients in the ED hallways, high number of patients placed off-service (meaning that they are sent to a unit corresponding to a different service), lack of available intensive care unit (ICU) beds, theatre cancellations, and hospital diversions [11][12][13][14][15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

Alternatives to conventional hospitalization for improving lack of access to inpatient beds: a 12-year cross-sectional analysis

Corbella

Ortiga²,

Juan³

et al. 2012

JHA

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Background/Objective: When hospitals cannot guarantee available hospital beds for inpatient admission, patients are exposed to prolonged waits, cancellations and diversions that negatively affect their safety and quality of care. The purpose of this study was to evaluate the effect of a multifaceted intervention for eliminating inpatient access delays.Methods: By using multi-time point cross-sectional analysis, data from all hospitalizations from adult patients registered at an 850-bed public, tertiary-care university hospital were compared from

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Access block and emergency department overcrowding

Cited by 162 publications

References 35 publications

Brennpunkt Notaufnahme

Brennpunkt Notaufnahme

Hacinamiento en los servicios de emergencia

Alternatives to conventional hospitalization for improving lack of access to inpatient beds: a 12-year cross-sectional analysis

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