Crowding, perceived crowding and workload in Dutch emergency departments: should we continue on the same road?

Mol, Sander; Gaakeer, Menno; Linden, Margareta; Baan-Kooman, E C Margré; Backus, Barbra E.; Ridder, Victor A. de

doi:10.1097/mej.0000000000001034

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…transfer to a catheterization room) [ 12 , 13 ]. For improvement of care for patients with undifferentiated complaints, similar to care of patients with myocardial infarction, it is important to first explore the entire ACC and to investigate factors associated with the time in ACC [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

From symptom onset to ED departure: understanding the acute care chain for patients with undifferentiated complaints: a prospective observational study

Claassen,

Ritter,

Latten

et al. 2024

Int J Emerg Med

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Background For most acute conditions, the phase prior to emergency department (ED) arrival is largely unexplored. However, this prehospital phase has proven an important part of the acute care chain (ACC) for specific time-sensitive conditions, such as stroke and myocardial infarction. For patients with undifferentiated complaints, exploration of the prehospital phase of the ACC may also offer a window of opportunity for improvement of care. This study aims to explore the ACC of ED patients with undifferentiated complaints, with specific emphasis on time in ACC and patient experience. Methods This Dutch prospective observational study, included all adult (≥ 18 years) ED patients with undifferentiated complaints over a 4-week period. We investigated the patients’ journey through the ACC, focusing on time in ACC and patient experience. Additionally, a multivariable linear regression analysis was employed to identify factors independently associated with time in ACC. Results Among the 286 ED patients with undifferentiated complaints, the median symptom duration prior to ED visit was 6 days (IQR 2–10), during which 58.6% of patients had contact with a healthcare provider before referral. General Practitioners (GPs) referred 80.4% of the patients, with the predominant patient journey (51.7%) involving GP referral followed by self-transportation to the ED. The median time in ACC was 5.5 (IQR 4.0-8.4) hours of which 40% was spent before the ED visit. GP referral and referral to pulmonology were associated with a longer time in ACC, while referral during evenings was associated with a shorter time in ACC. Patients scored both quality and duration of the provided care an 8/10. Conclusion Dutch ED patients with undifferentiated complaints consulted a healthcare provider in over half of the cases before their ED visit. The median time in ACC is 5.5 h of which 40% is spent in the prehospital phase. Those referred by a GP and to pulmonology had a longer, and those in the evening a shorter time in ACC. The acute care journey starts hours before patients arrive at the ED and 6 days of complaints precede this journey. This timeframe could serve as a window of opportunity to optimise care.

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Section: Introductionmentioning

confidence: 99%

From symptom onset to ED departure: understanding the acute care chain for patients with undifferentiated complaints: a prospective observational study

Claassen,

Ritter,

Latten

et al. 2024

Int J Emerg Med

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show abstract

“…First, the trivial issue of increasing ward bed space for emergency patients. Addressing the boarding crisis requires a multifaceted approach, focusing on both immediate and long-term strategies, particularly for geriatric patients [4,7]. The impact of ED crowding and crisis boarding on morbidity, mortality, medical error, staff burnout, and excessive cost are well documented [8].…”

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confidence: 99%

Increased mortality in elderly patients who spent the night in the emergency department: lessons from the ‘No Bed Night’ study?

Roussel

2024

European Journal of Emergency Medicine

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Deferring diagnostic evaluation for suspected deep venous thrombosis using a single dose of anticoagulant: Real-world data from a regionwide care pathway

Luu,

Mostard,

van Mil

et al. 2024

European Journal of Internal Medicine

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Crowding, perceived crowding and workload in Dutch emergency departments: should we continue on the same road?

Cited by 4 publications

References 12 publications

From symptom onset to ED departure: understanding the acute care chain for patients with undifferentiated complaints: a prospective observational study

From symptom onset to ED departure: understanding the acute care chain for patients with undifferentiated complaints: a prospective observational study

Increased mortality in elderly patients who spent the night in the emergency department: lessons from the ‘No Bed Night’ study?

Deferring diagnostic evaluation for suspected deep venous thrombosis using a single dose of anticoagulant: Real-world data from a regionwide care pathway

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