A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System
Yıl: 2014 Cilt: 14 Sayı: 2 Sayfa Aralığı: 64 - 70 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System
Öz: Amaç Acil servis kalabalığı tüm dünyada giderek yaygınlaşan bir sorundur. Hastanelerin acil servis kalabalık ölçütlerini kullanarak durum tespiti yapması ve uygun çözüm önerileri üretmeleri gereklidir.Gereç ve YöntemÇalışmamızda Hastane Bilgi Yönetim Sistemine ek bir program (Elektronik Blokaj Sistemi, EBS) yazıldı. Buna göre hastanede bulunan boş yatakların öncelikli olarak acil serviste yatış bekleyen hastalar için kullanılması planlandı. Acil serviste yatış bekleyen hasta varken, ilgili servislere yapılacak acil olmayan poliklinik yatışları bloke edildi. EBS başlamadan önceki dönem, EBS sonrası erken dönem ve EBS sonrası geç dönemde birer hafta boyunca NEDOCS skorlaması ile acil servis kalabalıklığı ölçüldü.BulgularElektronik blokaj sistemi sonrası erken dönemde diğer dönemlere göre NEDOCS değeri anlamlı olarak daha düşük bulundu (p<0.0001). Her üç dönemde de acil servise başvuran günlük hasta sayısı ve ölçüm anında mevcut olan hasta sayısı değişmediği halde, acil servis içinde yatış bekleyen hasta sayısı EBS sonrası erken dönemde, EBS öncesi ve EBS sonrası geç döneme göre anlamlı olarak daha azdı (p=0.0001, p=0.001).Sonuç Elektronik blokaj sistemi, acil hastaların poliklinik hastalarına göre öncelikli olarak hastaneye yatışını sağlayan, kalabalığı önlemeye yönelik bir çeşit yatış triajı sistemidir. Hastanedeki toplam yatak sayısının yeterli olmadığı hastanelerde, acil servis kalabalığını azaltmak için acil servisten hastaneye olan yatışları hızlandırmak amacıyla kullanılabilir.
Anahtar Kelime: Konular:
Acil Servis Kalabalığını Azaltmada Yeni Bir Model: Elektronik Blokaj Sistemi
Öz: ObjectivesEmergency department (ED) crowding is a growing problem across the world. Hospitals need to identify the situation using emergency department crowding scoring systems and to produce appropriate solutions.MethodsA new program (Electronic Blockage System, EBS) was written supplementary to the Hospital Information System. It was planned that the number of empty beds in the hospital should primarily be used for patients awaiting admission to a hospital bed at the ED. In the presence of patients awaiting admission at the ED, non-urgent admissions to other departments were blocked. ED overcrowded was measured in the period before initiation of EBS, the early post-EBS period and the late post-EBS period, of one-week's duration each, using NEDOCS scoring.ResultsNEDOCS values were significantly lower in the early post-EBS period compared to the other periods (p<0.0001). Although outpatient numbers applying to the ED and existing patient numbers at time of measurement remained unchanged in all three periods, the number of patients awaiting admission in the early post-EBS period was significantly lower than in the pre-EBS and late post-EBS periods (p=0.0001, p=0.001).ConclusionsEBS is a form of triage system aimed at preventing crowding and ensuring the priority admission of emergency patients over that of polyclinic patients. In hospitals with an insufficient number of total beds it can be used to reduce ED crowding and accelerate admissions to hospital from the ED.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Crowding (policy statement) Approved January 2006. Ameri- can College of Emergency Physicians. Access to: http://www. acep.org/content.aspx?id=29156. Accessed February 06, 2014. COLAK Bernstein SL, Aronsky D, Duseja R, Epstein S, Handel D, Hwang U, et al. The effect of emergency department crowding on clinically oriented outcomes. Acad Emerg Med 2009;16:1-10.
- Richardson DB. Increase in patient mortality at 10 days as- sociated with emergency department overcrowding. Med J Aust 2006;184:213-6.
- Derlet RW, Richards JR. Emergency department overcrowd- ing in Florida, New York, and Texas. South Med J 2002;95:846- 9.
- Jones SS, Allen TL, Flottemesch TJ, Welch SJ. An indepen- dent evaluation of four quantitative emergency department crowding scales. Acad Emerg Med 2006;13:1204-11.
- Bernstein SL, Verghese V, Leung W, Lunney AT, Perez I. Devel- opment and validation of a new index to measure emergen- cy department crowding. Acad Emerg Med 2003;10:938-42.
- Asplin BR, Rhodes KV, Flottemesch TJ, Wears R, Camargo CA, Hwang U, et al. Is this emergency department crowded? A multicenter derivation and evaluation of an emergen- cy department crowding scale (EDCS). Acad Emerg Med 2004;11:484-5.
- Weiss SJ, Derlet R, Arndahl J, Ernst AA, Richards J, Fernández- Frackelton M, et al. Estimating the degree of emergency de- partment overcrowding in academic medical centers: results of the National ED Overcrowding Study (NEDOCS). Acad Emerg Med 2004;11:38-50.
- Reeder TJ, Burleson DL, Garrison HG. The overcrowded emer- gency department: a comparison of staff perceptions. Acad Emerg Med 2003;10:1059-64.
- Hoot NR, Zhou C, Jones I, Aronsky D. Measuring and fore- casting emergency department crowding in real time. Ann Emerg Med 2007;49:747-55.
- Feferman I, Cornell C. How we solved the overcrowding prob- lem in our emergency department. CMAJ 1989;140:273-6.
- Hoot NR, Aronsky D. Systematic review of emergency depart- ment crowding: causes, effects, and solutions. Ann Emerg Med 2008;52:126-36.
- Harris A, Sharma A. Access block and overcrowding in emer- gency departments: an empirical analysis. Emerg Med J 2010;27:508-11.
| APA | ÇOLAK ORAY N, YANTURALI S, ATİLLA R, Ersoy G, TOPAÇOĞLU H (2014). A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. , 64 - 70. |
| Chicago | ÇOLAK ORAY Neşe,YANTURALI Sedat,ATİLLA Rıdvan,Ersoy Gurkan,TOPAÇOĞLU Hakan A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. (2014): 64 - 70. |
| MLA | ÇOLAK ORAY Neşe,YANTURALI Sedat,ATİLLA Rıdvan,Ersoy Gurkan,TOPAÇOĞLU Hakan A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. , 2014, ss.64 - 70. |
| AMA | ÇOLAK ORAY N,YANTURALI S,ATİLLA R,Ersoy G,TOPAÇOĞLU H A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. . 2014; 64 - 70. |
| Vancouver | ÇOLAK ORAY N,YANTURALI S,ATİLLA R,Ersoy G,TOPAÇOĞLU H A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. . 2014; 64 - 70. |
| IEEE | ÇOLAK ORAY N,YANTURALI S,ATİLLA R,Ersoy G,TOPAÇOĞLU H "A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System." , ss.64 - 70, 2014. |
| ISNAD | ÇOLAK ORAY, Neşe vd. "A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System". (2014), 64-70. |
| APA | ÇOLAK ORAY N, YANTURALI S, ATİLLA R, Ersoy G, TOPAÇOĞLU H (2014). A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. Türkiye Acil Tıp Dergisi, 14(2), 64 - 70. |
| Chicago | ÇOLAK ORAY Neşe,YANTURALI Sedat,ATİLLA Rıdvan,Ersoy Gurkan,TOPAÇOĞLU Hakan A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. Türkiye Acil Tıp Dergisi 14, no.2 (2014): 64 - 70. |
| MLA | ÇOLAK ORAY Neşe,YANTURALI Sedat,ATİLLA Rıdvan,Ersoy Gurkan,TOPAÇOĞLU Hakan A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. Türkiye Acil Tıp Dergisi, vol.14, no.2, 2014, ss.64 - 70. |
| AMA | ÇOLAK ORAY N,YANTURALI S,ATİLLA R,Ersoy G,TOPAÇOĞLU H A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. Türkiye Acil Tıp Dergisi. 2014; 14(2): 64 - 70. |
| Vancouver | ÇOLAK ORAY N,YANTURALI S,ATİLLA R,Ersoy G,TOPAÇOĞLU H A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System. Türkiye Acil Tıp Dergisi. 2014; 14(2): 64 - 70. |
| IEEE | ÇOLAK ORAY N,YANTURALI S,ATİLLA R,Ersoy G,TOPAÇOĞLU H "A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System." Türkiye Acil Tıp Dergisi, 14, ss.64 - 70, 2014. |
| ISNAD | ÇOLAK ORAY, Neşe vd. "A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System". Türkiye Acil Tıp Dergisi 14/2 (2014), 64-70. |
