The impact of emergency department segmentation and nursing staffing increase on inpatient mortality and management times

Facteurs influençant le délai de prise en charge aux urgences chirurgicales du CHU Sourô Sanou

INTRODUCTION

Assessing patient turnaround times is essential for improving the quality of care in emergency service departments.

PURPOSE OF THE RESEARCH

This study looked at waiting and treatment times, and their associated factors, in the surgical emergency service department at the Souro Sanou National Teaching Hospital (SSNTH) in Bobo-Dioulasso, Burkina Faso.

RESULTS

This study was carried out on 380 patients with a median age of thirty-eight. The sex ratio was 0.54. In 63.7 percent of cases, the participants lived in urban areas. Most of the patients surveyed were farmers (34.7 percent). The median waiting time for patients was eleven minutes. The nature of the trauma sustained was associated with the waiting time. The median time taken to administer first aid was sixty-three minutes, with the unavailability of medication at the hospital pharmacy cited as a factor contributing to this delay. The median time taken to obtain paraclinical results was 134 minutes and 102 minutes for laboratory tests and scans, respectively. The factor associated with delays in obtaining scan results was the need for surgical intervention. The median waiting time for surgery was 24.3 hours.

CONCLUSIONS

The turnaround times in the SSNTH surgical emergency department are long. For the improvement of patient turnaround times to be possible, an overhaul of the department is in order. In particular, a rapid consultation team needs to be established, and essential drugs for emergency care need to be made readily available.

Efficiency measures of emergency departments: an Italian systematic literature review

Life expectancy globally increased in the last decades: the number of people aged 65 or older is consequently projected to grow, and healthcare demand will increase as well. In the recent years, the number of patients visiting the hospital emergency departments (EDs) rocked in almost all countries of the world. These departments are crucial in all healthcare systems and play a critical role in providing an efficient assistance to all patients. A systematic literature review covering PubMed, Scopus and the Cochrane Library was performed from 2009 to 2019. Of the 718 references found in the literature research, more than 25 studies were included in the current review. Different predictors were associated with the quality of EDs care, which may help to define and implement preventive strategies in the near future. There is no harmonisation in efficiency measurements reflecting the performance in the ED setting. The identification of consistent measures of efficiency is crucial to build an evidence base for future initiatives. The aim of this study is to review the literature on the problems encountered in the efficiency of EDs around the world in order to identify an organisational model or guidelines that can be implemented in EDs to fill inefficiencies and ensure access optimal treatment both in terms of resources and timing. This review will support policy makers to improve the quality of health facilities, and, consequently of the entire healthcare systems.

Important factors for planning nurse staffing in the emergency department: A consensus study

INTRODUCTION

Planning adequate nurse staffing in the emergency department (ED) is challenging. Although there are models to determine nurse staffing in EDs, these models do not consider all the factors. Inadequate nurse staffing causes overcrowding, poor quality of patient care, increased hospital costs, poor patient outcomes and high levels of burnout amongst nurses. In this paper, we report stakeholders' perceptions of important factors to be considered when planning ED nursing ratios.

METHODS

We applied a consensus research design. The data was generated from modified nominal group techniques followed by an e-Delphi with two rounds. The factors were generated during two nominal groups by 19 stakeholders which included management and healthcare professionals working in EDs. The generated factors were then put on a survey format for use in an e-Delphi. Using purposive and snowball sampling the survey was distributed to 74 national and international experts for consensus.

RESULTS

Ultimately, 43 experts agreed (a validity index of ≥ 80%) on four categories namely: hospital, staff, patient and additional categories which included 17 related factors.

CONCLUSION

Ideal nurse staffing ratios are influenced by the complexity of the environment and interactions between multiple factors. The categories and factors identified emphasised the need for extensive further research to ensure a financially viable model that will be accepted by both staff and patient, and thus promote optimal outcomes.