Jessup Melanie, Crilly Julia, Boyle Justin, Wallis Marianne, Lind James, Green David, Fitzgerald Gerard
Australian Catholic University, Australia; Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Australia
Centre for Health Practice Innovation, Griffith Health Institute, Griffith University; Gold Coast University Hospital, Australia.
Health Informatics J. 2016 Sep;22(3):618-32. doi: 10.1177/1460458215577993. Epub 2015 Apr 27.
Emergency department overcrowding is an increasing issue impacting patients, staff and quality of care, resulting in poor patient and system outcomes. In order to facilitate better management of emergency department resources, a patient admission predictive tool was developed and implemented. Evaluation of the tool's accuracy and efficacy was complemented with a qualitative component that explicated the experiences of users and its impact upon their management strategies, and is the focus of this article. Semi-structured interviews were conducted with 15 pertinent users, including bed managers, after-hours managers, specialty department heads, nurse unit managers and hospital executives. Analysis realised dynamics of accuracy, facilitating communication and enabling group decision-making Users generally welcomed the enhanced potential to predict and plan following the incorporation of the patient admission predictive tool into their daily and weekly decision-making processes. They offered astute feedback with regard to their responses when faced with issues of capacity and communication. Participants reported an growing confidence in making informed decisions in a cultural context that is continually moving from reactive to proactive. This information will inform further patient admission predictive tool development specifically and implementation processes generally.
急诊科拥挤是一个日益严重的问题，影响着患者、工作人员和医疗质量，导致患者和系统的不良后果。为了更好地管理急诊科资源，开发并实施了一种患者入院预测工具。对该工具的准确性和有效性的评估辅以一个定性部分，该部分阐述了用户的体验及其对管理策略的影响，这也是本文的重点。对15名相关用户进行了半结构化访谈，包括床位管理人员、夜间管理人员、专科部门负责人、护士单元经理和医院管理人员。分析揭示了准确性、促进沟通和实现集体决策的动态过程。用户普遍欢迎在将患者入院预测工具纳入日常和每周决策过程后，预测和规划的潜力得到增强。他们就面对容量和沟通问题时的应对方式提供了敏锐的反馈。参与者报告说，在一个不断从被动反应转向积极主动的文化背景下，他们在做出明智决策时的信心越来越强。这些信息将为进一步开发患者入院预测工具以及总体实施过程提供参考。
