Hoping for a domino effect: a new specialty in Sweden is a breath of fresh air for the development of Scandinavian emergency medicine

Hallas, Peter; Ekelund, Ulf; Bjørnsen, Lars Petter; Brabrand, Mikkel

doi:10.1186/1757-7241-21-26

Cited by 11 publications

(7 citation statements)

References 2 publications

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“…Promotion of interdisciplinary teamwork and earlier senior physician involvement are examples of means to deliver timely and high quality treatment to patients within the EDs, which is essential for early diagnosis and provision of effective treatment of the increasing number of patients with comorbidities [4,5]. Other prevalent changes include introducing emergency medicine as a separate specialty [6] and formalised use of triage systems [7]. Many different ways of organising the ED is evolving and the costs and effects are being debated [8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of emergency department performance – a systematic review on recommended performance and quality-in-care measures

Sørup

Jacobsen

Forberg

2013

Scand J Trauma Resusc Emerg Med

110

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BackgroundEvaluation of emergency department (ED) performance remains a difficult task due to the lack of consensus on performance measures that reflects high quality, efficiency, and sustainability.AimTo describe, map, and critically evaluate which performance measures that the published literature regard as being most relevant in assessing overall ED performance.MethodsFollowing the PRISMA guidelines, a systematic literature review of review articles reporting accentuated ED performance measures was conducted in the databases of PubMed, Cochrane Library, and Web of Science. Study eligibility criteria includes: 1) the main purpose was to discuss, analyse, or promote performance measures best reflecting ED performance, 2) the article was a review article, and 3) the article reported macro-level performance measures, thus reflecting an overall departmental performance level.ResultsA number of articles addresses this study’s objective (n = 14 of 46 unique hits). Time intervals and patient-related measures were dominant in the identified performance measures in review articles from US, UK, Sweden and Canada. Length of stay (LOS), time between patient arrival to initial clinical assessment, and time between patient arrivals to admission were highlighted by the majority of articles. Concurrently, “patients left without being seen” (LWBS), unplanned re-attendance within a maximum of 72 hours, mortality/morbidity, and number of unintended incidents were the most highlighted performance measures that related directly to the patient. Performance measures related to employees were only stated in two of the 14 included articles.ConclusionsA total of 55 ED performance measures were identified. ED time intervals were the most recommended performance measures followed by patient centeredness and safety performance measures. ED employee related performance measures were rarely mentioned in the investigated literature. The study’s results allow for advancement towards improved performance measurement and standardised assessment across EDs.

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Section: Introductionmentioning

confidence: 99%

Evaluation of emergency department performance – a systematic review on recommended performance and quality-in-care measures

Sørup

Jacobsen

Forberg

2013

Scand J Trauma Resusc Emerg Med

110

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“…In developing countries, it might just have been a lack of access to available expertise and new technologies to force change in healthcare delivery. Despite the large variation in the speed of development, EM is now a specialty practised in over 50 countries …”

Section: Countries Where Emergency Medicine Has Not Flourishedmentioning

confidence: 99%

International emergency medicine: Past and future

Cameron

2014

Emerg Medicine Australasia

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Much has been written about the development of emergency medicine (EM) and its impact on the medical system as a whole. It is still described as 'new' and very much seen as a specialty that is evolving, rather than a static domain of knowledge and skills with rigid boundaries. In reality, the fundamentals of emergency treatment in mitigating the effects of acute illness and injury go back to ancient times.1 This is evidenced by descriptions of the urgent management of acute pain with analgesics, splinting of injured limbs, and more sophisticated procedures, such as the removal of kidney stones and craniotomies. The treatments at that time were limited, but the application of these skills brought relief to many people (and a little pain). The practitioners were generalists and did not limit themselves to emergency treatment alone.Over the past half-century, there has been an acceleration of development in emergency medical treatments and a massive explosion in emergency medical system enhancement. This has resulted in a unique body of knowledge and skills, with the evolution of a new medical specialty specific to the delivery of emergency medical care. It is worth reflecting on the drivers for EM specialisation, where the specialty has come from, and what we can expect as the complexity of medical care increases with technological innovation and social changes associated with increasing connectivity.

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“…The first paediatric resuscitation conference was held in 1983 under the auspices of the American Heart Association, 1 and in the UK it became a paediatric subspecialty in the mid-1980s. Emergency medicine is practised in 50 countries 2 worldwide but very few countries in Africa recognise paediatric emergency as a specialty per se. In a survey of African emergency care, Obermeyer et al were able to identify 192 facilities, just over half (n=107) were part of an academic health unit, only 11 (6%) were in rural areas and 36 (19%) were separate children’s departments.…”

Section: Introductionmentioning

confidence: 99%

Setting up and running a paediatric emergency department in a hospital in Malawi: 15 years on

Molyneux

Langton²,

Njirammadzi³

et al. 2017

bmjpo

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Paediatric emergency care is not recognised as a specialty in many countries in Africa but is being practised increasingly. Setting up a paediatric emergency care unit takes time and often involves trial and error. Here we describe the start of the paediatric emergency department in Blantyre, Malawi, a low-income country and how it has continued to evolve over 15 years, in the hope that our experience will inform and assist others who are already developing their own emergency unit or wishing to do so.

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Hoping for a domino effect: a new specialty in Sweden is a breath of fresh air for the development of Scandinavian emergency medicine

Cited by 11 publications

References 2 publications

Evaluation of emergency department performance – a systematic review on recommended performance and quality-in-care measures

Evaluation of emergency department performance – a systematic review on recommended performance and quality-in-care measures

International emergency medicine: Past and future

Setting up and running a paediatric emergency department in a hospital in Malawi: 15 years on

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