Gries A, Michel A, Bernhard M, Martin J
Zentrale Notaufnahme, Klinikum Fulda gAG, Pacelliallee 4, Fulda, Germany.
Anaesthesist. 2011 Jan;60(1):71-8. doi: 10.1007/s00101-010-1830-7.
In recent years the number of interdisciplinary emergency departments (ED) at hospitals in Germany has increased. The model of decentralized first contact units for each medical discipline has been abandoned, last but not least due to economic considerations. While decentralized units could be staffed with personnel from each discipline there is much controversy surrounding the question of which kind of doctor is best suited for a centralized ED. The development of programs providing the necessary qualification for German ED physicians in the future by working groups of several specialties is still nascent and has not yet produced concrete results. However, even without these special training programs, the management of critically ill or severely injured patients in the ED is paramount. The smooth operation of centralized EDs is therefore important. Therefore, taking into account economical aspects, qualification and number of available personnel, this article introduces a staffing concept as a rational basis for an optimized patient management in centralized EDs in Germany. Taking the patient characteristics, the specific treatment modalities and the number of admissions to the ED into account, this paper will determine treatment time per patient and the necessary number of physicians, as well as an optimized staffing model for EDs.
近年来，德国医院中跨学科急诊科的数量有所增加。每个医学学科设立分散式首诊单元的模式已被摒弃，这其中经济因素是一个重要原因。虽然分散式单元可以配备各学科的人员，但对于哪种医生最适合集中式急诊科这一问题仍存在诸多争议。由多个专业的工作组为德国急诊科医生提供未来所需资质的培训项目仍处于起步阶段，尚未产生具体成果。然而，即便没有这些特殊培训项目，急诊科对危重症或重伤患者的管理也是至关重要的。因此，集中式急诊科的顺畅运作很重要。所以，考虑到经济因素、人员资质及可用人数，本文引入一种人员配置理念，作为德国集中式急诊科优化患者管理的合理依据。本文将综合考虑患者特征、具体治疗方式及急诊科的入院人数，确定每位患者的治疗时间、所需医生数量以及急诊科的优化人员配置模式。
