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Junior doctor strike model of care: Reduced access block and predominant Fellow of the Australasian College for Emergency Medicine staffing improve emergency department performance.
Emerg Med Australas. 2008 Oct; 20(5):425-30.EM

Abstract

OBJECTIVE

To describe the response and analyse ED performance during a 5-day junior doctor strike.

METHODS

Data were collected via the patient information management computer system. Key performance indicators included percentage seen within maximum waiting times per triage category (TC), ED length of stay, emergency medicine patients who did not wait to be seen, hospital bed occupancy and access block percentage. Comparisons were made for the same 5 days before the strike (BS), during the strike (S) and after the strike.

RESULTS

Total doctor's shifts BS were 78.66 with 25% of these shifts being Fellow of the Australasian College for Emergency Medicine (FACEM) shifts. FACEM shifts were more common during the S period at 75% (P < 0.001). Total attendances (BS 631 vs S 596, P = 0.22) and TC percentages (P-values for TC 1, 2, 3, 4, 5, respectively, 1.0, 0.55, 0.88, 0.97, 0.46) in the BS, S and after-the-strike periods were not significantly different. Despite fewer total doctor shifts, the FACEM predominant model of care during the strike resulted in better percentages seen within the maximum waiting times for TC3 (66%), TC4 (78%) and TC5 (86%) (all P < 0.001). There was a reduction in patients who did not wait to be seen (28 BS vs 5 S, P < 0.001), ED length of stay (admissions: BS 451 min vs S 258 min, P < 0.001; discharges: BS 233 min vs S 144 min, P < 0.02) and referrals to inpatient services (P = 0.02). This occurred with reduced bed point occupancy of 66% and a consequent reduction in access block.

CONCLUSION

FACEM staffing and reduced access block were significant factors in improved ED performance.

Authors+Show Affiliations

Emergency Medicine Education and Research Middlemore Hospital, Auckland, New Zealand. vthornton@middlemore.co.nzNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

18973640

Citation

Thornton, Vanessa, and Wayne Hazell. "Junior Doctor Strike Model of Care: Reduced Access Block and Predominant Fellow of the Australasian College for Emergency Medicine Staffing Improve Emergency Department Performance." Emergency Medicine Australasia : EMA, vol. 20, no. 5, 2008, pp. 425-30.
Thornton V, Hazell W. Junior doctor strike model of care: Reduced access block and predominant Fellow of the Australasian College for Emergency Medicine staffing improve emergency department performance. Emerg Med Australas. 2008;20(5):425-30.
Thornton, V., & Hazell, W. (2008). Junior doctor strike model of care: Reduced access block and predominant Fellow of the Australasian College for Emergency Medicine staffing improve emergency department performance. Emergency Medicine Australasia : EMA, 20(5), 425-30. https://doi.org/10.1111/j.1742-6723.2008.01117.x
Thornton V, Hazell W. Junior Doctor Strike Model of Care: Reduced Access Block and Predominant Fellow of the Australasian College for Emergency Medicine Staffing Improve Emergency Department Performance. Emerg Med Australas. 2008;20(5):425-30. PubMed PMID: 18973640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Junior doctor strike model of care: Reduced access block and predominant Fellow of the Australasian College for Emergency Medicine staffing improve emergency department performance. AU - Thornton,Vanessa, AU - Hazell,Wayne, PY - 2008/11/1/pubmed PY - 2009/3/12/medline PY - 2008/11/1/entrez SP - 425 EP - 30 JF - Emergency medicine Australasia : EMA JO - Emerg Med Australas VL - 20 IS - 5 N2 - OBJECTIVE: To describe the response and analyse ED performance during a 5-day junior doctor strike. METHODS: Data were collected via the patient information management computer system. Key performance indicators included percentage seen within maximum waiting times per triage category (TC), ED length of stay, emergency medicine patients who did not wait to be seen, hospital bed occupancy and access block percentage. Comparisons were made for the same 5 days before the strike (BS), during the strike (S) and after the strike. RESULTS: Total doctor's shifts BS were 78.66 with 25% of these shifts being Fellow of the Australasian College for Emergency Medicine (FACEM) shifts. FACEM shifts were more common during the S period at 75% (P < 0.001). Total attendances (BS 631 vs S 596, P = 0.22) and TC percentages (P-values for TC 1, 2, 3, 4, 5, respectively, 1.0, 0.55, 0.88, 0.97, 0.46) in the BS, S and after-the-strike periods were not significantly different. Despite fewer total doctor shifts, the FACEM predominant model of care during the strike resulted in better percentages seen within the maximum waiting times for TC3 (66%), TC4 (78%) and TC5 (86%) (all P < 0.001). There was a reduction in patients who did not wait to be seen (28 BS vs 5 S, P < 0.001), ED length of stay (admissions: BS 451 min vs S 258 min, P < 0.001; discharges: BS 233 min vs S 144 min, P < 0.02) and referrals to inpatient services (P = 0.02). This occurred with reduced bed point occupancy of 66% and a consequent reduction in access block. CONCLUSION: FACEM staffing and reduced access block were significant factors in improved ED performance. SN - 1742-6723 UR - https://www.unboundmedicine.com/medline/citation/18973640/Junior_doctor_strike_model_of_care:_Reduced_access_block_and_predominant_Fellow_of_the_Australasian_College_for_Emergency_Medicine_staffing_improve_emergency_department_performance_ L2 - https://doi.org/10.1111/j.1742-6723.2008.01117.x DB - PRIME DP - Unbound Medicine ER -