Acil servis konsültasyonlarında çağrı ve telefon sistemlerinin etkinlikleri ile danışılan hastaların acilde kalış sürelerinin karşılaştırmalı çalışması
Öz
Amaç:
Tüm dünyada Acil Servis Hekimleri konsültasyon istemlerini gerçekleştirmek için
farklı araçlar ya da sistemler kullanmaktadır. Dahili telefonlar, çağrı
cihazları, konsültasyon istasyonları, cep telefonları ve akıllı telefonlar sık
kullanılan örneklerdir. Bu tercihleri pratikte zaman ve teknoloji ile değişen
bir eğilim izlemektedir. Biz bu çalışmada konsültasyonlarda kullanılan dâhili
telefonlar ile çağrı cihazlarının etkinliklerini değerlendirdik ve üçüncü
basamak bir Eğitim ve Araştırma hastanesinde hastaların acil serviste bekleme
süreleri (ABS) üzerine etkilerini araştırdık.
Gereç ve Yöntemler: Çalışma prospektif ve tanımlayıcı olarak planlanmıştır.
AS'de konsültasyon istenen hastalar çalışma grubu olarak seçilmiştir. Dahili
telefonlar ve merkezi işletim sistemli çağrı cihazları ayrı ayrı ve sırasıyla
AS konsültasyon istemleri için 2 haftalık periyotlar halinde kullanılmıştır.
ABS ve konsültasyon cevaplama süreleri (KCS) değerlendirilmiştir.
Bulgular:
Toplam 228 hastadan 318 konsültasyon istenmiştir. En çok konsültasyon istenen
bölümler Kardiyoloji (17.6%), Genel Cerrahi (14.2%) ve Ortopedi'dir (13.5%).
Telefon ve çağrı cihazları bölümlerden bağımsız olarak karşılaştırıldıklarında,
telefonla tespit edilen KCS değerleri çağrı cihazlarına göre belirgin uzun
tespit edilmiştir (52 dk vs. 18 dk; p=0.56, p=0.04). ABS telefon için 353 dk
iken çağrı cihazı için 314 dk olarak bulundu ancak bu sonuçlar istatistiksel
olarak anlamlı değildi(p>0.05).
Sonuç:
Çağrı cihazlar AS hekimleri için konsültasyon istemleri için zaman ve enerjiden
tasarruf ettiren bir seçenektir. Ek olarak aciliyeti yüksek hastalar için
KCS'yi kısaltmaktadır. Ancak AKS açısından iki yöntemle ilgili anlamlı bir fark
tespit edilememiştir.
Anahtar Kelimeler
Kaynakça
- 1. Rosen P. Emergency department disposition and knowledge of other specialties. J Emerg Med 1986; 4: 325-26.
- 2. Tintinalli JE, McCall K. Importance of emergency physicians as referral sources for academic medical centers. Ann Emerg Med 1994; 23: 65-69.
- 3.Cho SJ, Jeong J. Decreased emergency department length of stay by application of a computerized consultation management system. Academic Emergency Medicine 2011; 18: 398–402.
- 4. Li G, Lau JT, McCarthy ML et al. Emergency department utilization in the United States and Ontario, Canada. AcadEmerg Med 2007; 14: 582–84.
- 5. Olshaker JS, Rathlev NK. Emergency department overcrowding and ambulance diversion: The impact and potential solutions of extended boarding of admitted patients in the emergency department. J Emerg Med 2006; 30: 351–56.
- 6. Richardson S, Ardagh M, Hider P. New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department. N Z Med J 2006; 119: 1933.
- 7. Barber Perez P, Gonzalez Lopez, Valcarcel B. Stimulation of a Hospital Emergency Department and Its Potential Use in Management. GacSanit 1994; 8: 239–47.
- 8. Woods R, Lee R. Consultation outcomes in the emergency department: exploring rates and complexity. CJEM 2008; 10: 25-31.
- 9. Kessler C, Kutka BM, Badillo C. Consultation in the Emergency Department: A Qualitative Analysis and Review. J Emerg Med 2011; 42: 704-11
- 10. Holliman JC. The Art Of Dealing With Consultants: The Journal Of Emergency Medicine 1993; 11: 633-40.
- 11. Lee RS, Woods R, Bullard M. Consultations in the emergency department: a systematic review of the literature. Emerg Med J 2008; 25: 4–9.
- 12. Brenner BE, Holmes TM, Simpsin DDT et al. Reducing specialty consultation times in the emergency department [abstract]. Acad Emerg Med 2004; 11:463.
- 13. Williams S, Crouch R. Emergency department patient classification systems: A systematic review. AccidEmergNurs 2006 Jul; 14: 160-70.
- 14. Williams S, Crouch R. Patient dependency in the emergency department (ED): Reliability and validity of the Jones Dependency Tool (JDT). Accident and Emergency Nursing 2006; 14: 219-29.
- 15. http://www.saglik.gov.tr/TR/belge/1-13438/saglik-istatistikleri-yilligi-2010.html
- 16. Young GP, Wagner MB, Kellerman AL et al. Ambulatory visits to hospital emergency departments. JAMA 1996; 276: 460–65.
- 17. http://www.cdc.gov/nchs/data/nhsr/nhsr026.pdf
- 18. Lambe S, Washington DL, Fink A et al. Waiting time in California’s emergency departmants. Ann. Emerg. Med 2003; 44: 35–43.
- 19. Hexter DA. Working with consultants. ACEP Foresight 2002; 53
- 20. Vincent TS. The art of consultation. Res Staff Phys 1987; 33: 116-20.
- 21. Bender AS. Commandments for consultants. Res Staff Phys 1986; 32:122-23.
- 22. Gutterman JJ, Franaszek JB, Murdy D et al. The 1980 patient urgency study: Further analysis of the data. Ann Emergy Med 1985; 12: 1191–98.
- 23. Kellar DK, Chaturvedi SK, Malhotra SA. A study of emergency psychiatric referrals in a teaching hospital. India J Psychiatry 1982; 24: 366-69.
- 24. Yoon P, Steiner I, Reinhardt G. Analysis of factors influencing length of stay in the emergency department. Can J Emerg. Med 2003; 5: 155-61
- 25. Cortazzo JM, Guertler AT, Rice MM. Consultation and referral patterns from a teaching hospital emergency department. Am J Emerg Med 1993; 11: 456-59
- 26. Curry DG, Wang DM. Variations of consultation practice in urban emergency physicians (abstract). Can J Emerg. Med 2006; 8: 182-83
A comparison study on the effectiveness of pager and telephone systems during emergency department consultations and length of stay of consulted emergency department patients
Öz
Aim: Emergency department
(ED) physicians use different tools and modalities to communicate with
consulted clinical divisions in all over the world. Domestic phones, pagers,
consultation stations, mobile phones and smart phone applications are commonly
used examples. They have a changing trend over time and technology in practice.
We evaluated the effectiveness of the consultations conducted by telephone and
pager systems, compared the functionality of both systems and investigated
their effects on length of stay (LOS) of the patients in the ED of a tertiary
teaching hospital.
Material and methods: The study was planned
as prospective and descriptive. The consulted patients in ED were assigned for
the study group. The domestic telephones and pagers with central operating system
were used as an ED consultation tool for a two-week period, respectively and separately.
LOS and consultation response time (CRT) were evaluated.
Results: Three hundred eighteen
consultations were requested for a total of 228 patients. The most frequently
requested consultations were from Cardiology (17.6%), General Surgery (14.2%)
and Orthopaedics (13.5%). When the telephone and pager systems were compared
independently from the departments, CRT was found significantly longer via telephone
compared to pager (52 min vs. 18 min; p=0.56, p=0.04). The LOS was 353 min for
telephone, 314 min for pager but these results were not statistically
significant (p>0.05).
Conclusion: The pager system
for consultation request is a time and energy reducing option for ED physicians.
In addition, it shortens CRT for the patients with high urgency levels. However
there is no significant difference between both methods on LOS.
Anahtar Kelimeler
emergency department consultation communication pager telephone
Kaynakça
- 1. Rosen P. Emergency department disposition and knowledge of other specialties. J Emerg Med 1986; 4: 325-26.
- 2. Tintinalli JE, McCall K. Importance of emergency physicians as referral sources for academic medical centers. Ann Emerg Med 1994; 23: 65-69.
- 3.Cho SJ, Jeong J. Decreased emergency department length of stay by application of a computerized consultation management system. Academic Emergency Medicine 2011; 18: 398–402.
- 4. Li G, Lau JT, McCarthy ML et al. Emergency department utilization in the United States and Ontario, Canada. AcadEmerg Med 2007; 14: 582–84.
- 5. Olshaker JS, Rathlev NK. Emergency department overcrowding and ambulance diversion: The impact and potential solutions of extended boarding of admitted patients in the emergency department. J Emerg Med 2006; 30: 351–56.
- 6. Richardson S, Ardagh M, Hider P. New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department. N Z Med J 2006; 119: 1933.
- 7. Barber Perez P, Gonzalez Lopez, Valcarcel B. Stimulation of a Hospital Emergency Department and Its Potential Use in Management. GacSanit 1994; 8: 239–47.
- 8. Woods R, Lee R. Consultation outcomes in the emergency department: exploring rates and complexity. CJEM 2008; 10: 25-31.
- 9. Kessler C, Kutka BM, Badillo C. Consultation in the Emergency Department: A Qualitative Analysis and Review. J Emerg Med 2011; 42: 704-11
- 10. Holliman JC. The Art Of Dealing With Consultants: The Journal Of Emergency Medicine 1993; 11: 633-40.
- 11. Lee RS, Woods R, Bullard M. Consultations in the emergency department: a systematic review of the literature. Emerg Med J 2008; 25: 4–9.
- 12. Brenner BE, Holmes TM, Simpsin DDT et al. Reducing specialty consultation times in the emergency department [abstract]. Acad Emerg Med 2004; 11:463.
- 13. Williams S, Crouch R. Emergency department patient classification systems: A systematic review. AccidEmergNurs 2006 Jul; 14: 160-70.
- 14. Williams S, Crouch R. Patient dependency in the emergency department (ED): Reliability and validity of the Jones Dependency Tool (JDT). Accident and Emergency Nursing 2006; 14: 219-29.
- 15. http://www.saglik.gov.tr/TR/belge/1-13438/saglik-istatistikleri-yilligi-2010.html
- 16. Young GP, Wagner MB, Kellerman AL et al. Ambulatory visits to hospital emergency departments. JAMA 1996; 276: 460–65.
- 17. http://www.cdc.gov/nchs/data/nhsr/nhsr026.pdf
- 18. Lambe S, Washington DL, Fink A et al. Waiting time in California’s emergency departmants. Ann. Emerg. Med 2003; 44: 35–43.
- 19. Hexter DA. Working with consultants. ACEP Foresight 2002; 53
- 20. Vincent TS. The art of consultation. Res Staff Phys 1987; 33: 116-20.
- 21. Bender AS. Commandments for consultants. Res Staff Phys 1986; 32:122-23.
- 22. Gutterman JJ, Franaszek JB, Murdy D et al. The 1980 patient urgency study: Further analysis of the data. Ann Emergy Med 1985; 12: 1191–98.
- 23. Kellar DK, Chaturvedi SK, Malhotra SA. A study of emergency psychiatric referrals in a teaching hospital. India J Psychiatry 1982; 24: 366-69.
- 24. Yoon P, Steiner I, Reinhardt G. Analysis of factors influencing length of stay in the emergency department. Can J Emerg. Med 2003; 5: 155-61
- 25. Cortazzo JM, Guertler AT, Rice MM. Consultation and referral patterns from a teaching hospital emergency department. Am J Emerg Med 1993; 11: 456-59
- 26. Curry DG, Wang DM. Variations of consultation practice in urban emergency physicians (abstract). Can J Emerg. Med 2006; 8: 182-83
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Özgün Makale |
| Yazarlar | |
| Yayımlanma Tarihi | 21 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 10 Sayı: 1 |
Kaynak Göster
Cited By
A short review on the comparison of consultation systems and tools in the emergency department practice: Tele-consultation
Cumhuriyet Medical Journal
Sevilay Vural
https://doi.org/10.7197/223.vi.568582
e-ISSN: 2149-8296
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