Richardson Sandra, Ardagh Michael, Hider Philip
Emergency Department, Christchurch Hospital, Christchurch.
N Z Med J. 2006 Apr 21;119(1232):U1933.
Emergency Departments (EDs) worldwide are facing a crisis from overcrowding--a common perception exists that inappropriate use of the ED is the major contributing factor. This study aims to examine the concept of 'inappropriate' ED attendances in relation to the Emergency Department at New Zealand's Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'.
An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of ED patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'.
There are significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the ED.
While there are some areas of general agreement, there is no clear consensus between the professionals surveyed regarding the concept of 'appropriateness.' This has implications for any interventions aimed at addressing ED 'overcrowding' that assume the presence of a consensus understanding of this concept.
全球范围内的急诊科都面临着过度拥挤的危机——人们普遍认为急诊科的不当使用是主要促成因素。本研究旨在探讨新西兰克赖斯特彻奇医院急诊科“不当”就诊的概念。具体而言，它试图确定医疗服务提供者之间对于“不当”的定义是否存在共识性意见。
对参与克赖斯特彻奇急诊科患者转诊、评估、转运和治疗的卫生专业人员进行了一项探索性调查。涉及一系列卫生专业人员，包括救护人员、全科医生、急诊科医生、急诊护士和医院管理人员。询问了一系列与“不当”患者的定义和应对措施相关的问题，以及一个与“恰当性”定义相关的开放式问题。
参与患者转诊、治疗和收住急诊科的关键卫生专业人员的态度和看法存在显著差异。
虽然存在一些普遍认同的领域，但接受调查的专业人员对于“恰当性”概念并未达成明确共识。这对于任何旨在解决急诊科“过度拥挤”问题且假定对该概念存在共识性理解的干预措施都具有影响。
