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1.
Scand J Trauma Resusc Emerg Med ; 22: 60, 2014 Nov 05.
Article in English | MEDLINE | ID: mdl-25370418

ABSTRACT

BACKGROUND: The Emergency Departments (EDs) reorganization process in Denmark began in 2007 and includes creating a single entrance for all emergency patients, establishing triage, having a specialist in the front and introducing the use of electronic overview boards and electronic patient files. The aim of this study was to investigate the quality of acute care in a re-organized ED based on national indicator project data in a pre and post reorganizational setting. METHODS: Quasi experimental design was used to examine the effect of the health care quality in relation to the reorganization of an ED. Patients admitted at Nykøbing Falster Hospital in 2008 or 2012 were included in the study and data reports from the national databases (RKKP) regarding stroke, COPD, heart failure, bleeding and perforated ulcer or hip fracture were analysed. Holbæk Hospital works as a control hospital. Chi-square test was used for analysing significant differences from pre-and post intervention and Z-test to compare the experimental groups to the control group (HOL). P < 0.05 was considered statistically significant. RESULTS: We assessed 4584 patient cases from RKKP. A significant positive change was seen in all of the additional eight indicators related to stroke at NFS (P < 0.001); however, COPD indicators were unchanged in both hospitals. In NFS two of eight heart failure indicators were significantly improved after the reorganization (p < 0.01). In patients admitted with a bleeding ulcer 2 of 5 indicators were significantly improved after the reorganization in NFS and HOL (p < 0.01). Both compared hospitals showed significant improvements in the two indicators concerning hip fracture (p < 0.001). Significant reductions in the 30 day-mortality in patients admitted with stroke were seen when the pre- and the post-intervention data were compared for both NFS and HOL (p = 0.024). CONCLUSIONS: During the organisation of the new EDs, several of the indicators improved and the overall 30 days mortality decreased in the five diseases. The development of a common set of indicators for monitoring acute treatment at EDs in Denmark is recommended.


Subject(s)
Critical Care/standards , Critical Illness/therapy , Emergencies , Emergency Service, Hospital/organization & administration , Quality Improvement , Quality Indicators, Health Care/standards , Registries , Adult , Aged , Aged, 80 and over , Critical Care/trends , Denmark , Female , Humans , Male , Middle Aged , Retrospective Studies
2.
Ugeskr Laeger ; 176(30): 1396-8, 2014 Jul 21.
Article in Danish | MEDLINE | ID: mdl-25292231

ABSTRACT

In Denmark, hospitals in these years reorganize the overall acute treatment of patients with the aim of providing better quality of treatment during several common interventions. This paper presents a status of the limited number of Danish studies, which have examined the acute care and knowledge about the planned interventions in the emergency departments. The new concept for the reception and treatment of emergency patients opens up new areas of research in a Danish context. The number of preliminary published results that have been presented by Danish acute conferences testify this.


Subject(s)
Emergency Service, Hospital , Clinical Competence , Denmark , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/standards , Emergency Treatment/standards , Humans , Patient Admission , Quality of Health Care , Risk Assessment , Triage
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