FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2129146077> ?p ?o ?g. }

• W2129146077 endingPage "564" @default.
• W2129146077 startingPage "564" @default.
• W2129146077 abstract "Objective To implement and evaluate strategies for improving access to emergency department (ED) care in a tertiary hospital. Methods A retrospective pre–post intervention study using routinely collected data involving all patients presenting acutely to the ED of a major tertiary hospital over a 2-year period. Main outcome measures were changes in: the percentage of patients exiting the ED (all patients, patients discharged directly from the ED, patients admitted to inpatient wards); mean patient transit times in the ED; inpatient mortality rates; rates of ED ‘did not wait’ and re-presentations within 48 h of ED discharge; and selected safety indicators. Qualitative data on staff perceptions of interventions were also gathered. Results Working groups focused on ED internal processes, ED–inpatient unit interface, hospital-wide discharge processes and performance monitoring and feedback. Twenty-five different reforms were enacted over a 9-month period from April to December 2012. Comparing the baseline period (January–March 2012) with the post-reform period (January–March 2013), the percentage of patients exiting the ED within 4 h rose for all patients presenting to the ED (from 32% to 62%), for patients discharged directly from the ED (from 41% to 75%) and for admitted patients (from 12% to 32%; P < 0.001 for all comparisons). The mean (±s.d.) time all patients spent in the ED was reduced from 7.2 ± 5.8 to 4.4 ± 3.5 h (P < 0.001) and, for admitted patients, was associated with reduced in-hospital mortality (from 2.3% to 1.7%; P = 0.045). The ‘did not wait’ rates in ED fell from 6.9% to 1.9% (P < 0.001), whereas ED re-presentations within 48 h among patients discharged from the ED rose slightly (from 3.1% to 3.8%; P = 0.023). Improvements in outcome measures were maintained over the subsequent 12 months. Conclusions Multiple reforms targeting processes both within the ED and its interface with inpatient units greatly improved access to ED care over 12 months and were associated with decreased in-hospital mortality. What is known about this topic? Prolonged stays in the ED result in overcrowding, delayed ambulance access to ED care and increased adverse outcomes for admitted patients. The introduction in Australia of National Emergency Access Targets (NEAT), which stipulate at least 70% of patients in the ED must exit the department within 4 h, have spurred hospitals into implementing a wide range of reforms with varying levels of success in achieving such targets. What does this paper add? This study demonstrates how multiple reforms implemented in a poor performing tertiary hospital caused the proportion of patients exiting the ED within 4 h to double within 9 months to reach levels comparable with best performing peer hospitals. This was associated with a 26% reduction in in-hospital mortality for admitted patients and no clinically significant adverse effects. It demonstrates the importance of robust governance structures, executive sponsorship, cross-disciplinary collaboration, regular feedback of NEAT performance data and major redesign of existing clinical processes, work practices and bed management operations. What are the implications for clinicians and managers? Improving access to emergency care should be regarded as a problem located and resolved both within and without the ED. It requires a whole-of-hospital solution involving interdisciplinary collaboration and significant change in culture and practice relating to inpatient units and their interface with the ED." @default.
• W2129146077 created "2016-06-24" @default.
• W2129146077 creator A5002098356 @default.
• W2129146077 creator A5012610139 @default.
• W2129146077 creator A5038310377 @default.
• W2129146077 creator A5040200812 @default.
• W2129146077 creator A5057603989 @default.
• W2129146077 creator A5066437970 @default.
• W2129146077 creator A5087188888 @default.
• W2129146077 date "2014-01-01" @default.
• W2129146077 modified "2023-09-26" @default.
• W2129146077 title "Aiming to be NEAT: safely improving and sustaining access to emergency care in a tertiary referral hospital" @default.
• W2129146077 cites W11246522 @default.
• W2129146077 cites W125064766 @default.
• W2129146077 cites W1580239062 @default.
• W2129146077 cites W1899655634 @default.
• W2129146077 cites W1950876837 @default.
• W2129146077 cites W1986297202 @default.
• W2129146077 cites W2003991887 @default.
• W2129146077 cites W2007744576 @default.
• W2129146077 cites W2045553720 @default.
• W2129146077 cites W2082293473 @default.
• W2129146077 cites W2086140666 @default.
• W2129146077 cites W2086672942 @default.
• W2129146077 cites W2104233517 @default.
• W2129146077 cites W2110358548 @default.
• W2129146077 cites W2132033829 @default.
• W2129146077 cites W2151126344 @default.
• W2129146077 cites W2152931091 @default.
• W2129146077 cites W2312665305 @default.
• W2129146077 cites W3140272185 @default.
• W2129146077 cites W33172232 @default.
• W2129146077 cites W4256436395 @default.
• W2129146077 doi "https://doi.org/10.1071/ah14083" @default.
• W2129146077 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/25297518" @default.
• W2129146077 hasPublicationYear "2014" @default.
• W2129146077 type Work @default.
• W2129146077 sameAs 2129146077 @default.
• W2129146077 citedByCount "48" @default.
• W2129146077 countsByYear W21291460772015 @default.
• W2129146077 countsByYear W21291460772016 @default.
• W2129146077 countsByYear W21291460772017 @default.
• W2129146077 countsByYear W21291460772018 @default.
• W2129146077 countsByYear W21291460772019 @default.
• W2129146077 countsByYear W21291460772020 @default.
• W2129146077 countsByYear W21291460772021 @default.
• W2129146077 countsByYear W21291460772022 @default.
• W2129146077 countsByYear W21291460772023 @default.
• W2129146077 crossrefType "journal-article" @default.
• W2129146077 hasAuthorship W2129146077A5002098356 @default.
• W2129146077 hasAuthorship W2129146077A5012610139 @default.
• W2129146077 hasAuthorship W2129146077A5038310377 @default.
• W2129146077 hasAuthorship W2129146077A5040200812 @default.
• W2129146077 hasAuthorship W2129146077A5057603989 @default.
• W2129146077 hasAuthorship W2129146077A5066437970 @default.
• W2129146077 hasAuthorship W2129146077A5087188888 @default.
• W2129146077 hasBestOaLocation W21291460771 @default.
• W2129146077 hasConcept C126322002 @default.
• W2129146077 hasConcept C159110408 @default.
• W2129146077 hasConcept C167135981 @default.
• W2129146077 hasConcept C194828623 @default.
• W2129146077 hasConcept C27415008 @default.
• W2129146077 hasConcept C2776135927 @default.
• W2129146077 hasConcept C2780283434 @default.
• W2129146077 hasConcept C2780724011 @default.
• W2129146077 hasConcept C512399662 @default.
• W2129146077 hasConcept C71924100 @default.
• W2129146077 hasConceptScore W2129146077C126322002 @default.
• W2129146077 hasConceptScore W2129146077C159110408 @default.
• W2129146077 hasConceptScore W2129146077C167135981 @default.
• W2129146077 hasConceptScore W2129146077C194828623 @default.
• W2129146077 hasConceptScore W2129146077C27415008 @default.
• W2129146077 hasConceptScore W2129146077C2776135927 @default.
• W2129146077 hasConceptScore W2129146077C2780283434 @default.
• W2129146077 hasConceptScore W2129146077C2780724011 @default.
• W2129146077 hasConceptScore W2129146077C512399662 @default.
• W2129146077 hasConceptScore W2129146077C71924100 @default.
• W2129146077 hasIssue "5" @default.
• W2129146077 hasLocation W21291460771 @default.
• W2129146077 hasLocation W21291460772 @default.
• W2129146077 hasOpenAccess W2129146077 @default.
• W2129146077 hasPrimaryLocation W21291460771 @default.
• W2129146077 hasRelatedWork W2026095104 @default.
• W2129146077 hasRelatedWork W2042489430 @default.
• W2129146077 hasRelatedWork W2787439413 @default.
• W2129146077 hasRelatedWork W2902975202 @default.
• W2129146077 hasRelatedWork W2958398583 @default.
• W2129146077 hasRelatedWork W3035671959 @default.
• W2129146077 hasRelatedWork W3092029925 @default.
• W2129146077 hasRelatedWork W3133536779 @default.
• W2129146077 hasRelatedWork W3185360602 @default.
• W2129146077 hasRelatedWork W4312728004 @default.
• W2129146077 hasVolume "38" @default.
• W2129146077 isParatext "false" @default.
• W2129146077 isRetracted "false" @default.
• W2129146077 magId "2129146077" @default.
• W2129146077 workType "article" @default.