Rixon Andrew, Wilson Samuel, Judkins Simon, White Peter
Department of Business Technology and Entrepreneurship, Swinburne University of Technology, Melbourne, Victoria, Australia.
Department of Management and Marketing, Swinburne University of Technology, Melbourne, Victoria, Australia.
Emerg Med Australas. 2020 Aug;32(4):679-682. doi: 10.1111/1742-6723.13523. Epub 2020 May 20.
To identify opportunities for directors of emergency medicine (DEMs) to lead change efforts to address ED crowding and access block.
DEMs were surveyed about their beliefs about, barriers to, and enablers of solutions to ED crowding and access block.
Key barriers were insufficient resources, entrenched hospital culture, and lack of political will to address ED crowding and access block. Key enablers were developing hospital-wide understanding of the problems, developing a supportive hospital culture, and improved engagement by hospital executive.
Addressing the political and cultural forces that sustain ED crowding and access block are key adaptive challenges requiring DEM leadership.
确定急诊医学主任（DEMs）引领变革努力以解决急诊科拥挤和准入障碍问题的机会。
对急诊医学主任进行调查，了解他们对急诊科拥挤和准入障碍解决方案的看法、障碍及促成因素。
主要障碍包括资源不足、根深蒂固的医院文化以及解决急诊科拥挤和准入障碍的政治意愿缺失。主要促成因素包括在全院范围内增进对这些问题的理解、营造支持性的医院文化以及医院行政人员加强参与。
应对导致急诊科拥挤和准入障碍的政治和文化力量是需要急诊医学主任发挥领导作用的关键适应性挑战。
