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Bir Üniversite Hastanesi Acil Servis Performansının Sağlıkta Kalite Standartları Göstergeleri Kapsamında Değerlendirilmesi

Year 2023, , 1222 - 1235, 25.11.2023
https://doi.org/10.21076/vizyoner.1293166

Abstract

Bu araştırmada, bir üniversite hastanesi acil servis performansının Sağlıkta Kalite Standartları göstergeleri kapsamında değerlendirilmesi amaçlanmıştır. Çalışma tanımlayıcı nitelikte kesitsel tipte tasarlanmıştır. Çalışmanın evrenini, üniversite hastanesinde 01.01.2021-31.12.2021 tarihleri arasında Sağlık Bakanlığı acil servis göstergeleri kapsamında takip edilen; acil servise yeniden başvuru oranı, konsültan hekimin acil servise ortalama ulaşma süresi, acil serviste ortalama müşahede süresi ve hasta sevk oranı kayıtları oluşturmaktadır. Çalışmada örneklem seçilmemiş ve evrenin tamamı değerlendirmeye alınmıştır. Veri toplama aracı olarak acil servis gösterge kartı kullanılmıştır. Verilerin analizinde Sağlık Bakanlığı gösterge kartlarında belirtilen hesaplama yöntemleri kullanılmıştır. Çalışmada acil servise aynı şikayetle yeniden başvuru oranının %0,002 olduğu ve performans hedefi olarak belirlenen değere (%1) ulaşıldığı tespit edilmiştir. Acil servis ortalama müşahede süresinin 2021 yılı ortalamasının 93 dakika olduğu ve kurumsal hedefe (720 dakika) ulaşıldığı görülmüştür. Konsültan hekimin acile ulaşma süresinin 2021 yılı için ortalama 32 dakika olduğu ve hedef değer olarak belirlenen 30 dakikanın aşıldığı bulunmuştur. Çalışmada hasta sevk oranının (%0,001) hedeflenen değerin (%1) altında olduğu tespit edilmiştir. Çalışma sonucunda acil servise yeniden başvuru oranı, acil servis ortalama müşahede süresi ve hasta sevk oranı için hedefe ulaşıldığı, konsültan hekimin acil servise ulaşma süresi için kurumsal düzeyde hedeflenen değere ulaşılamadığı ve bu konuda iyileştirme çalışmasına ihtiyaç olduğu tespit edilmiştir.

Ethical Statement

Bu çalışma için Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Girişimsel Olmayan Araştırmalar Etik Kurulundan 2022-1/211 sayılı ve 12.01.2023 tarihli etik kurul onayı alınmıştır.

References

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  • Ahsan, K. B., Alam, M. R., Morel, D. G. ve Karim, M. A. (2019a). Emergency department resource optimisation for improved performance: a review. Journal of Industrial Engineering International, 15, 253-266. https://doi.org/10.1007/s40092-019-00335-x.
  • Ahsan, K. B., Karim, M., FitzGerald, G. J., Morel, D. G. ve Burke, J. A. (2019b). Development of relationship between triaging of patients and emergency department performance. Procedia Manufacturing, 30, 200-207. https://doi.org/10.1016/j.promfg.2019.02.029
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  • Etu, E. E., Monplaisir, L., Aguwa, C., Arslanturk, S., Masoud, S., Markevych, I. ve Miller, J. (2022). Identifying indicators influencing emergency department performance during a medical surge: A consensus-based modified fuzzy Delphi approach. PLoS One, 17(4), e0265101. https://doi.org/10.1371/journal.pone.0265101
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Evaluation of the Emergency Department Performance of a University Hospital within the Scope of Health Quality Standards Indicators

Year 2023, , 1222 - 1235, 25.11.2023
https://doi.org/10.21076/vizyoner.1293166

Abstract

The study aims to evaluate the emergency department performance of a university hospital within the scope of Health Quality Standards indicators. Descriptive and cross-sectional research methods are used to design the study. The population of the study, which is followed up in a university hospital between January 1st, 2021, and December 31st, 2021, within the scope of the Ministry of Health emergency service indicators, include the rate of re-admissions to the emergency department, the average time of reaching the emergency department by the consultant physician, the average observation time in the emergency department, and the rate of patient referral. No sample is selected for the study, and the entire universe is evaluated. The tool used for collecting data is the emergency department indicator card. In the analysis of the data, the calculation methods specified in the indicator cards by the Ministry of Health are used. According to the study, the rate of revisits to the emergency department with the same complaint is 0.002%, and the performance target of 1% is reached. It is observed that the average observation time in the emergency department is 93 minutes, and the target of 720 minutes is reached. It is found that the time for the consultant physician to reach the emergency department is 32 minutes in 2021, and the target for this indicator is exceeded by 30 minutes. It is found that the patient referral rate (0.001%) is well below the target (1%). As a result of the study, the target is reached for the rate of revisits to the emergency department, the average hospitalization time in the emergency department, and the patient referral rate, but the target for the consultant physician's time to reach the emergency department could not be reached, and in this regard there is a need for an improvement.

Ethical Statement

Bu çalışma için Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Girişimsel Olmayan Araştırmalar Etik Kurulundan 2022-1/211 sayılı ve 12.01.2023 tarihli etik kurul onayı alınmıştır.

References

  • Aaronson, E. L., Marsh, R. H., Guha, M., Schuur, J. D. ve Rouhani, S. A. (2015). Emergency department quality and safety indicators in resource-limited settings: an environmental survey. International Journal of Emergency Medicine, 8(1), 39. https://doi.org/10.1186/s12245-015-0088-x
  • Ahsan, K. B., Alam, M. R., Morel, D. G. ve Karim, M. A. (2019a). Emergency department resource optimisation for improved performance: a review. Journal of Industrial Engineering International, 15, 253-266. https://doi.org/10.1007/s40092-019-00335-x.
  • Ahsan, K. B., Karim, M., FitzGerald, G. J., Morel, D. G. ve Burke, J. A. (2019b). Development of relationship between triaging of patients and emergency department performance. Procedia Manufacturing, 30, 200-207. https://doi.org/10.1016/j.promfg.2019.02.029
  • Akçay, G. ve Gül, Ö. (2022). Çocuk acil servisine yeniden başvuran vakaların demografik ve klinik özelliklerinin değerlendirilmesi. Sağlık Akademisyenleri Dergisi, 9(3), 280-285.
  • Akenroye, A. T., Thurm, C. W., Neuman, M. I., Alpern, E. R., Srivastava, G., Spencer, S. P., …. ve Stack, A. M. (2014). Prevalence and predictors of return visits to pediatric emergency departments. Journal of Hospital Medicine, 9(12), 779-787. https://doi.org/10.1002/jhm.2273
  • Al Nhdi, N., Al Asmari, H. ve Al Thobaity, A. (2021). Investigating ındicators of waiting time and length of stay in emergency departments. Open Access Emergency Medicine, 13, 311-318. https://doi.org/10.2147/OAEM.S316366
  • Al-Refaie, A., Fouad, R. H., Li, M-H. ve Shurrab, M. (2014). Applying simulation and DEA to improve performance of emergency department in a Jordanian hospital, Simulation Modelling Practice and Theory, 41, 59-72. https://doi.org/10.1016/j.simpat.2013.11.010
  • Aydın, T., Aydın, Ş. A., Köksal, Ö., Özdemir, F., Kulaç, S., … ve Bulut, M. (2010). Uludağ Üniversitesi Tıp Fakültesi Hastanesi acil servisine başvuran hastaların özelliklerinin ve acil servis çalışmalarının değerlendirilmesi. Akademik Acil Tıp Dergisi, 9, 163-168.
  • Beattie, E. ve Mackway-Jones, K. (2004). A Delphi study to identify performance indicators for emergency medicine. Emergency Medicine Journal, 21(1), 47-50. https://doi.org/ 10.1136/emj.2003.001123
  • Beckerleg, W., Wooller, K. ve Hasimjia, D. (2020). Interventions to reduce emergency department consultation time: A systematic review of the literature. Canadian Journal of Emergency Medicine, 22(1), 56-64. https://doi.org/10.1017/cem.2019.435
  • Broccoli, M. C., Moresky, R., Dixon, J., Muya, I., Taubman, C., Wallis, L. A. ve Calvello Hynes, E. J. (2018). Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa. BMJ Global Health, 3(1), e000479. https://doi.org/ 10.1136/bmjgh-2017-000479
  • Casalino, E., Choquet, C., Bernard, J., Debit A, Doumenc, B., Berthoumieu, A. ve Wargon, M. (2013). Predictive variables of an emergency department quality and performance indicator: a 1-year prospective, observational, cohort study evaluating hospital and emergency census variables and emergency department time interval measurements. Emergency Medicine Journal, 30(8), 638-645. https://doi.org/10.1136/emermed-2012-201404
  • Cheng, S. Y., Wang, H. T., Lee, C. W., Tsai, T. C., Hung, C. W. ve Wu, K. H. (2013). The characteristics and prognostic predictors of unplanned hospital admission within 72 hours after ED discharge. American Journal of Emergency Medicine, 31(10), 1490-1494. https://doi.org/10.1016/j.ajem.2013.08.004
  • Cooke, M. W., Arora, P. ve Mason, S. (2003). Discharge from triage: modelling the potential in different types of emergency department. Emergency Medicine Journal, 20(2), 131-133. http://dx.doi.org/10.1136/emj.20.2.131
  • Çaparlar, C. Ö. ve Dönmez, A. (2016). What is scientific research and how can it be done? Turkish Journal of Anaesthesiology and Reanimation, 44(4), 212-218. https://doi.10.5152/TJAR.2016.34711
  • Davey, L. (1990). The application of case study evaluations. Practical Assessment, Research, and Evaluation, 2(9), 1-2. https://doi.org/10.7275/02g8-bb93
  • de Steenwinkel, M., Haagsma, J. A., van Berkel, E. C. M., Rozema, L., Rood, P. P. M. ve Bouwhuis, M. G. (2022). Patient satisfaction, needs, and preferences concerning information dispensation at the emergency department: a cross-sectional observational study. International Journal of Emergency Medicine, 15(5), 1-8. https://doi.org/10.1186/s12245-022-00407-7
  • Dowd, B., Karmarker, M., Swenson, T., Parashuram, S., Kane, R., Coulam, R., … ve Jeffery, M. M. (2014). Emergency department utilization as a measure of physician performance. American Journal of Medial Quality, 29(2), 135-43. https://doi.org/10.1177/1062860613487196
  • Ekşi, M. A. ve Tekin, D. (2021). Unscheduled revisits within 24 hours to the pediatric emergency department: a first single-center prospective study in Turkey. Anatolian Journal of Emergency Medicine, 4(2), 49-54. Enard, K. R. ve Ganelin, D. M. (2013). Reducing preventable emergency department utilization and costs by using community health workers as patient navigators. Journal of Health Management, 58(6), 412-427. Engeloğlu, Ş., Yenimahalleli Yaşar, G. ve Günaltay, M. M. (2022). Ankara ilinde konsültan hekimlerin acil servise ulaşma sürelerinin ve bu süreleri etkileyen faktörlerin incelenmesi. Politik Ekonomik Kuram, 6(2), 371-395. https://doi.org/10.30586/pek.1130631
  • Erenler, A. K., Akbulut, S., Guzel, M., Cetinkaya, H., Karaca, A., Turkoz, B. ve Baydin, A. (2014). Reasons for overcrowding in the emergency department: experiences and suggestions of an education and research hospital. Turkish Journal of Emergency Medicine, 14(2), 59-63. https://doi.org/10.5505/1304.7361.2014.48802
  • Ersel, M., Karcıoğlu, Ö., Yanturalı, S., Yürüktümen, A., Sever, M. ve Tunç, M. (2006). Bir acil servisin kullaı›m özellikleri ve başvuran hastaların aciliyetinin hekim ve hasta açısından değerlendirilmesi. Türkiye Acil Tıp Dergisi, 6(1), 25-35.
  • Esen, H., Şengöz, T. Ç. ve Karaca, A. (2022). Covid-19 hastalarının acil servise tekrar başvuru oranı ve klinik özellikleri: tek merkezli çalışma. Online Türk Sağlık Bilimleri Dergisi, 7(4), 609-615. https://doi.org/10.26453/otjhs.1140897
  • Etu, E. E., Monplaisir, L., Aguwa, C., Arslanturk, S., Masoud, S., Markevych, I. ve Miller, J. (2022). Identifying indicators influencing emergency department performance during a medical surge: A consensus-based modified fuzzy Delphi approach. PLoS One, 17(4), e0265101. https://doi.org/10.1371/journal.pone.0265101
  • Hu, K. W., Lu, Y. H., Lin, H. J., Guo, H. R. ve Foo, N. P. (2012). Unscheduled return visits with and without admission post emergency department discharge. Journal of Emergency Medicine, 43(6), 1110-1118. https://doi.org/10.1016/j.jemermed.2012.01.062
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There are 48 citations in total.

Details

Primary Language Turkish
Subjects Health Policy
Journal Section Research Articles
Authors

Yasemin Aslan 0000-0001-6292-2332

Publication Date November 25, 2023
Submission Date May 5, 2023
Published in Issue Year 2023

Cite

APA Aslan, Y. (2023). Bir Üniversite Hastanesi Acil Servis Performansının Sağlıkta Kalite Standartları Göstergeleri Kapsamında Değerlendirilmesi. Süleyman Demirel Üniversitesi Vizyoner Dergisi, 14(40), 1222-1235. https://doi.org/10.21076/vizyoner.1293166

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