The complex causes of delays in A&amp;E

Pickard, Diane; Bulbeck, Kate; Woolmore, Ashley

doi:10.1016/j.aaen.2003.12.005

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…This study has demonstrated the feasibility and value of using a mixed-method approach to identify factors influencing patient flow within an A&E department. This study increased the volume and quality of data in this research area and also improved staff awareness of the influence of internal factors on patient flow as documented by Pickard et al 11 This study will contribute to evidence-based decision making for the local management team in the prioritization of projects in this specific area. Although many interesting factors were identified throughout this study, they may not be generalizable to other A&E departments.…”

Section: Discussionmentioning

confidence: 62%

Using mixed methods to identify factors influencing patient flow

Vaerenbergh¹

2009

Health Serv Manage Res

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An effective method of identifying operational factors that influence patient flow can potentially lead to improvements and thus have huge benefits on the efficiency of hospital departments. This paper presents a new inductive mixed-method approach to identify operational factors that influence patient flow through an accident and emergency (A&E) department. Preliminary explorative observations were conducted, followed by semi-structured interviews with key stakeholders. A questionnaire survey of all medical, nursing, porter and clerical staff was then conducted. The observations provided factors for further exploration: skill-mix, long working hours, equipment availability, lack of orientation programmes, inefficient IT use and issues regarding communication structures. Interviewees highlighted several factors, including availability of medical supervision and senior nursing staff, nursing documentation issues, lack of morale due to overcrowding, personality differences and factors relating to the department layout. The questionnaire respondents strongly supported the importance of the previously identified factors. This paper demonstrates an effective mixed-method approach that can be replicated by other health-care managers to identify factors influencing patient flow. Further benefits include increased volume and quality of data, increased staff awareness for the influence of internal factors on patient flow and enhancing the evidence base for future decision making when prioritizing A&E projects.

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Section: Discussionmentioning

confidence: 62%

Using mixed methods to identify factors influencing patient flow

Vaerenbergh¹

2009

Health Serv Manage Res

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“…Nor are 'scrapers' unique to the Toalean period, being reported from Pleistocene deposits as well as beyond the known Toalean geographical distribution [e.g. 33,88].…”

Section: Cores [Batu Inti]mentioning

confidence: 99%

“…In ISEA, bipolar reduction has been reported at a number of Pleistocene and Holocene sites [e.g. 83, 94, 101], including the Pleistocene assemblages in South Sulawesi of Leang Bulu Bettue [34], Leang Sakapao 1 [33,102], and Leang Burung 2 [35,103]. The technique was also practiced in the historic period in Papua New Guinea [96].…”

Section: Cores [Batu Inti]mentioning

confidence: 99%

“…This profile contrasts with Late Pleistocene deposits, which lack the diagnostic Toalean artefact types and are instead dominated by unmodified flakes, small bipolar artefacts, and large cores [33][34][35][36]. The limestone caves of Maros and Pangkep are rich in parietal ochre paintings, and while these were initially assumed to be Toalean [16,37], recent dates obtained from multiple paintings have all returned Pleistocene origins [38][39][40][41].…”

Section: Introductionmentioning

confidence: 99%

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A standardised classification scheme for the Mid-Holocene Toalean artefacts of South Sulawesi, Indonesia

et al. 2021

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The archaeology of Sulawesi is important for developing an understanding of human dispersal and occupation of central Island Southeast Asia. Through over a century of archaeological work, multiple human populations in the southwestern region of Sulawesi have been identified, the most well-documented being that of the Mid- to Late Holocene ‘Toalean’ technological period. Archaeological models for this period describe a population with a strong cultural identity, subdivided into groups living on the coastal plains around Maros as well as dispersed upland forest dwellers, hunting endemic wildlife with bow-and-arrow technology. It has been proposed that the Toaleans were capable of vast water-crossings, with possible cultural exchange with northern Australia, Java, and Japan. This Toalean paradigm is built almost exclusively on existing interpretations of distinctive Toalean stone and bone artefact technologies, constructed on out-dated 19th and 20th century theory. Moreover, current definitions of Toalean artefact types are inconsistently applied and unsystematic, and the manufacturing sequence has historically been poorly understood. To address these problems in existing artefact models and typologies, we present a clarified typology of the Toalean artefacts of South Sulawesi, and describe the technical aspects of artefact production. This typology provides a tool for standardising research and will facilitate more meaningful assessments of material culture repertoires and more reliable assessment of spatial and temporal changes for the region.

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“…Many research efforts are taken to study and improve these problems (Saunders, 1987;de Vries et al, 1999;Alvarez and Centeno, 2000;Derlet and Richards, 2000;Asplin et al, 2003;Puente et al, 2003;Pickard et al, 2004;Kelly et al, 2007). In the Netherlands, a four-year PhD research in operations management (OM) is under way, focusing its efforts on all patient flow aspects of a large university hospital's emergency department.…”

Section: Introductionmentioning

confidence: 99%

Improving healthcare delivery with lean thinking

Rosmulder¹

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The complex causes of delays in A&E

Cited by 5 publications

References 8 publications

Using mixed methods to identify factors influencing patient flow

Using mixed methods to identify factors influencing patient flow

A standardised classification scheme for the Mid-Holocene Toalean artefacts of South Sulawesi, Indonesia

Improving healthcare delivery with lean thinking

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