Hospital-integrated general practice: a promising way to manage walk-in patients in emergency departments
Rationale, aims and objectives The inappropriate use and overcrowding of emergency departments (EDs) by walk‐in patients are well‐known problems in many countries. The current study aimed to determine whether ambulatory walk‐in patients could be treated more efficiently in a new hospital‐integrated...
Gespeichert in:
| Veröffentlicht in: | Journal of evaluation in clinical practice 2014-02, Vol.20 (1), p.20-26 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 26 |
|---|---|
| container_issue | 1 |
| container_start_page | 20 |
| container_title | Journal of evaluation in clinical practice |
| container_volume | 20 |
| creator | Wang, Mathyas Wild, Stefanie Hilfiker, Gabriela Chmiel, Corinne Sidler, Patrick Eichler, Klaus Rosemann, Thomas Senn, Oliver |
| description | Rationale, aims and objectives
The inappropriate use and overcrowding of emergency departments (EDs) by walk‐in patients are well‐known problems in many countries. The current study aimed to determine whether ambulatory walk‐in patients could be treated more efficiently in a new hospital‐integrated general practice (HGP) for emergency care services compared to a traditional ED.
Methods
We conducted a pre‐post comparison before and after the implementation of a new HGP. Participants were walk‐in patients attending the ED of a city hospital in Zurich. Main outcome measures were differences in total process time, time intervals between stages of care and diagnostic resources used.
Results
The median process time from admission to discharge was 120 minutes in the ED [interquartile range (IQR): 80–165] versus 60 minutes in the HGP (IQR: 40–90) (P |
| doi_str_mv | 10.1111/jep.12074 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1490774635</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1490774635</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3634-9e1a83babdfb0038f37bb1483b8b0923778c8da8d78759b6de71d2d2d4027fc33</originalsourceid><addsrcrecordid>eNp1kEtP5DAQhC3EitfugT-AfIRDwE47ccINIXaARYDErjhanaQzMuSF7RE7_x4PA9ywDy7bX5Vaxdi-FMcyrpMnmo5lKrTaYDsS8ixJdQabK53liUxLtc12vX8SQoLI9BbbTpUAUBJ2mL0c_WQDdokdAs0dBmr4nAZy2PHJYR1sTaccox576-0w56-45GHkPQ44p3jrnqOXTxgsDcHzqKknFzPqJW9oQhf61cdP9qPFztOvj3OP_ft98ff8Mrm5m12dn90kNeSgkpIkFlBh1bSVEFC0oKtKqvhUVKJMQeuiLhosGl3orKzyhrRs0riVSHVbA-yxw3VunPhlQT6YOHdNXYcDjQtvpCqF1iqHLKJHa7R2o_eOWjM526NbGinMqlkTmzXvzUb24CN2UfXUfJGfVUbgZA282o6W3yeZ64v7z8hk7bA-0P8vB7pnk2vQmXm8nZmHWSau_xQP5hHeAL5bksg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1490774635</pqid></control><display><type>article</type><title>Hospital-integrated general practice: a promising way to manage walk-in patients in emergency departments</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><creator>Wang, Mathyas ; Wild, Stefanie ; Hilfiker, Gabriela ; Chmiel, Corinne ; Sidler, Patrick ; Eichler, Klaus ; Rosemann, Thomas ; Senn, Oliver</creator><creatorcontrib>Wang, Mathyas ; Wild, Stefanie ; Hilfiker, Gabriela ; Chmiel, Corinne ; Sidler, Patrick ; Eichler, Klaus ; Rosemann, Thomas ; Senn, Oliver</creatorcontrib><description>Rationale, aims and objectives
The inappropriate use and overcrowding of emergency departments (EDs) by walk‐in patients are well‐known problems in many countries. The current study aimed to determine whether ambulatory walk‐in patients could be treated more efficiently in a new hospital‐integrated general practice (HGP) for emergency care services compared to a traditional ED.
Methods
We conducted a pre‐post comparison before and after the implementation of a new HGP. Participants were walk‐in patients attending the ED of a city hospital in Zurich. Main outcome measures were differences in total process time, time intervals between stages of care and diagnostic resources used.
Results
The median process time from admission to discharge was 120 minutes in the ED [interquartile range (IQR): 80–165] versus 60 minutes in the HGP (IQR: 40–90) (P < 0.001). The adjusted odds ratio of receiving any additional diagnostics was 1.86 (95% confidence interval 1.06–3.27; P = 0.032) for ED doctors versus general practitioners (GPs) when controlling for patients' age, sex and injury‐related medical problems.
Conclusion
The HGP is an efficient way to manage walk‐in patients with regard to process time and utilization of additional diagnostic resources. The involvement of GPs in the HGPs should be considered as a promising model to overcome the inappropriate use of resources in EDs for walk‐in patients who can be treated by ambulatory care.</description><identifier>ISSN: 1356-1294</identifier><identifier>EISSN: 1365-2753</identifier><identifier>DOI: 10.1111/jep.12074</identifier><identifier>PMID: 24033413</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Ambulatory Care - organization & administration ; emergency care ; Emergency Service, Hospital - organization & administration ; Female ; General Practice - organization & administration ; Humans ; implementation ; Male ; Middle Aged ; out-of-hours care ; primary care ; self-referral ; Systems Integration ; Time Factors ; Triage ; walk-in patients</subject><ispartof>Journal of evaluation in clinical practice, 2014-02, Vol.20 (1), p.20-26</ispartof><rights>2013 John Wiley & Sons, Ltd</rights><rights>2013 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3634-9e1a83babdfb0038f37bb1483b8b0923778c8da8d78759b6de71d2d2d4027fc33</citedby><cites>FETCH-LOGICAL-c3634-9e1a83babdfb0038f37bb1483b8b0923778c8da8d78759b6de71d2d2d4027fc33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjep.12074$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjep.12074$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24033413$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Mathyas</creatorcontrib><creatorcontrib>Wild, Stefanie</creatorcontrib><creatorcontrib>Hilfiker, Gabriela</creatorcontrib><creatorcontrib>Chmiel, Corinne</creatorcontrib><creatorcontrib>Sidler, Patrick</creatorcontrib><creatorcontrib>Eichler, Klaus</creatorcontrib><creatorcontrib>Rosemann, Thomas</creatorcontrib><creatorcontrib>Senn, Oliver</creatorcontrib><title>Hospital-integrated general practice: a promising way to manage walk-in patients in emergency departments</title><title>Journal of evaluation in clinical practice</title><addtitle>J Eval Clin Pract</addtitle><description>Rationale, aims and objectives
The inappropriate use and overcrowding of emergency departments (EDs) by walk‐in patients are well‐known problems in many countries. The current study aimed to determine whether ambulatory walk‐in patients could be treated more efficiently in a new hospital‐integrated general practice (HGP) for emergency care services compared to a traditional ED.
Methods
We conducted a pre‐post comparison before and after the implementation of a new HGP. Participants were walk‐in patients attending the ED of a city hospital in Zurich. Main outcome measures were differences in total process time, time intervals between stages of care and diagnostic resources used.
Results
The median process time from admission to discharge was 120 minutes in the ED [interquartile range (IQR): 80–165] versus 60 minutes in the HGP (IQR: 40–90) (P < 0.001). The adjusted odds ratio of receiving any additional diagnostics was 1.86 (95% confidence interval 1.06–3.27; P = 0.032) for ED doctors versus general practitioners (GPs) when controlling for patients' age, sex and injury‐related medical problems.
Conclusion
The HGP is an efficient way to manage walk‐in patients with regard to process time and utilization of additional diagnostic resources. The involvement of GPs in the HGPs should be considered as a promising model to overcome the inappropriate use of resources in EDs for walk‐in patients who can be treated by ambulatory care.</description><subject>Adult</subject><subject>Ambulatory Care - organization & administration</subject><subject>emergency care</subject><subject>Emergency Service, Hospital - organization & administration</subject><subject>Female</subject><subject>General Practice - organization & administration</subject><subject>Humans</subject><subject>implementation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>out-of-hours care</subject><subject>primary care</subject><subject>self-referral</subject><subject>Systems Integration</subject><subject>Time Factors</subject><subject>Triage</subject><subject>walk-in patients</subject><issn>1356-1294</issn><issn>1365-2753</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtP5DAQhC3EitfugT-AfIRDwE47ccINIXaARYDErjhanaQzMuSF7RE7_x4PA9ywDy7bX5Vaxdi-FMcyrpMnmo5lKrTaYDsS8ixJdQabK53liUxLtc12vX8SQoLI9BbbTpUAUBJ2mL0c_WQDdokdAs0dBmr4nAZy2PHJYR1sTaccox576-0w56-45GHkPQ44p3jrnqOXTxgsDcHzqKknFzPqJW9oQhf61cdP9qPFztOvj3OP_ft98ff8Mrm5m12dn90kNeSgkpIkFlBh1bSVEFC0oKtKqvhUVKJMQeuiLhosGl3orKzyhrRs0riVSHVbA-yxw3VunPhlQT6YOHdNXYcDjQtvpCqF1iqHLKJHa7R2o_eOWjM526NbGinMqlkTmzXvzUb24CN2UfXUfJGfVUbgZA282o6W3yeZ64v7z8hk7bA-0P8vB7pnk2vQmXm8nZmHWSau_xQP5hHeAL5bksg</recordid><startdate>201402</startdate><enddate>201402</enddate><creator>Wang, Mathyas</creator><creator>Wild, Stefanie</creator><creator>Hilfiker, Gabriela</creator><creator>Chmiel, Corinne</creator><creator>Sidler, Patrick</creator><creator>Eichler, Klaus</creator><creator>Rosemann, Thomas</creator><creator>Senn, Oliver</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201402</creationdate><title>Hospital-integrated general practice: a promising way to manage walk-in patients in emergency departments</title><author>Wang, Mathyas ; Wild, Stefanie ; Hilfiker, Gabriela ; Chmiel, Corinne ; Sidler, Patrick ; Eichler, Klaus ; Rosemann, Thomas ; Senn, Oliver</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3634-9e1a83babdfb0038f37bb1483b8b0923778c8da8d78759b6de71d2d2d4027fc33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Ambulatory Care - organization & administration</topic><topic>emergency care</topic><topic>Emergency Service, Hospital - organization & administration</topic><topic>Female</topic><topic>General Practice - organization & administration</topic><topic>Humans</topic><topic>implementation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>out-of-hours care</topic><topic>primary care</topic><topic>self-referral</topic><topic>Systems Integration</topic><topic>Time Factors</topic><topic>Triage</topic><topic>walk-in patients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Mathyas</creatorcontrib><creatorcontrib>Wild, Stefanie</creatorcontrib><creatorcontrib>Hilfiker, Gabriela</creatorcontrib><creatorcontrib>Chmiel, Corinne</creatorcontrib><creatorcontrib>Sidler, Patrick</creatorcontrib><creatorcontrib>Eichler, Klaus</creatorcontrib><creatorcontrib>Rosemann, Thomas</creatorcontrib><creatorcontrib>Senn, Oliver</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of evaluation in clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Mathyas</au><au>Wild, Stefanie</au><au>Hilfiker, Gabriela</au><au>Chmiel, Corinne</au><au>Sidler, Patrick</au><au>Eichler, Klaus</au><au>Rosemann, Thomas</au><au>Senn, Oliver</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hospital-integrated general practice: a promising way to manage walk-in patients in emergency departments</atitle><jtitle>Journal of evaluation in clinical practice</jtitle><addtitle>J Eval Clin Pract</addtitle><date>2014-02</date><risdate>2014</risdate><volume>20</volume><issue>1</issue><spage>20</spage><epage>26</epage><pages>20-26</pages><issn>1356-1294</issn><eissn>1365-2753</eissn><abstract>Rationale, aims and objectives
The inappropriate use and overcrowding of emergency departments (EDs) by walk‐in patients are well‐known problems in many countries. The current study aimed to determine whether ambulatory walk‐in patients could be treated more efficiently in a new hospital‐integrated general practice (HGP) for emergency care services compared to a traditional ED.
Methods
We conducted a pre‐post comparison before and after the implementation of a new HGP. Participants were walk‐in patients attending the ED of a city hospital in Zurich. Main outcome measures were differences in total process time, time intervals between stages of care and diagnostic resources used.
Results
The median process time from admission to discharge was 120 minutes in the ED [interquartile range (IQR): 80–165] versus 60 minutes in the HGP (IQR: 40–90) (P < 0.001). The adjusted odds ratio of receiving any additional diagnostics was 1.86 (95% confidence interval 1.06–3.27; P = 0.032) for ED doctors versus general practitioners (GPs) when controlling for patients' age, sex and injury‐related medical problems.
Conclusion
The HGP is an efficient way to manage walk‐in patients with regard to process time and utilization of additional diagnostic resources. The involvement of GPs in the HGPs should be considered as a promising model to overcome the inappropriate use of resources in EDs for walk‐in patients who can be treated by ambulatory care.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>24033413</pmid><doi>10.1111/jep.12074</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1356-1294 |
| ispartof | Journal of evaluation in clinical practice, 2014-02, Vol.20 (1), p.20-26 |
| issn | 1356-1294 1365-2753 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1490774635 |
| source | Wiley-Blackwell Journals; MEDLINE |
| subjects | Adult Ambulatory Care - organization & administration emergency care Emergency Service, Hospital - organization & administration Female General Practice - organization & administration Humans implementation Male Middle Aged out-of-hours care primary care self-referral Systems Integration Time Factors Triage walk-in patients |
| title | Hospital-integrated general practice: a promising way to manage walk-in patients in emergency departments |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T22%3A07%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hospital-integrated%20general%20practice:%20a%20promising%20way%20to%20manage%20walk-in%20patients%20in%20emergency%20departments&rft.jtitle=Journal%20of%20evaluation%20in%20clinical%20practice&rft.au=Wang,%20Mathyas&rft.date=2014-02&rft.volume=20&rft.issue=1&rft.spage=20&rft.epage=26&rft.pages=20-26&rft.issn=1356-1294&rft.eissn=1365-2753&rft_id=info:doi/10.1111/jep.12074&rft_dat=%3Cproquest_cross%3E1490774635%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1490774635&rft_id=info:pmid/24033413&rfr_iscdi=true |