scholarly journals The Meaning of Boarding in a Swedish Accident & Emergency Department: A Qualitative Study on Patients’ Experiences of Awaiting Admission

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 66
Author(s):  
Andreas Rantala ◽  
Sören Nordh ◽  
Mergime Dvorani ◽  
Anna Forsberg
Keyword(s):  
Emergency Department ◽  
European Union ◽  
Structural Analysis ◽  
Professional Ethics ◽  
Healthcare Professionals ◽  
The European Union ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Hospital Beds ◽  
Hermeneutic Approach

The number of in-hospital beds in Sweden has decreased during recent decades, resulting in the smallest number (2.2 available beds/1000 inhabitants) within the European Union. At the same time, the number of patients attending Accident and Emergency (A&E) departments has increased, resulting in overcrowding and boarding. The aim of this study was to explore the meaning of being subjected to boarding at an A&E department, as experienced by patients. A phenomenological-hermeneutic approach was chosen to interpret and understand the meaning of boarding at A&E. The study was carried out at a hospital in the south of Sweden. Seventeen participants with a mean age of 64 years (range: 35–86 years) were interviewed. The thematic structural analysis covers seven themes: Being in a state of uncertainty, Feeling abandoned, Fearing death, Enduring, Adjusting to the circumstances, Being a visitor in an unsafe place, and Acknowledging the staff, all illustrating that the participants were in a state of constant uncertainty and felt abandoned with no guidance or support from the clinicians. The conclusion is that the situation where patients are forced to wait in A&E, i.e., boarding, violates all conditions for professional ethics, presumably causing profound ethical stress in the healthcare professionals involved. Thus, boarding should be avoided.

scholarly journals Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study

2015 ◽  
Vol 4 (5) ◽  
pp. 47 ◽  
Author(s):  
Jean Claude Byiringiro ◽  
Rex Wong ◽  
Caroline Davis ◽  
Jeffery Williams ◽  
Joseph Becker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Success Factors ◽  
Low Cost ◽  
Post Intervention ◽  
Triage System ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
The Impact

Few case studies exist related to hospital accident and emergency department (A&E) quality improvement efforts in lowerresourced settings. We sought to report the impact of quality improvement principles applied to A&E overcrowding and flow in the largest referral and teaching hospital in Rwanda. A pre- and post-intervention study was conducted. A linked set of strategies included reallocating room space based on patient/visitor demand and flow, redirecting traffic, establishing a patient triage system and installing white boards to facilitate communication. Two months post-implementation, the average number of patients boarding in the A&E hallways significantly decreased from 28 (pre-intervention) to zero (post-intervention), p < .001. Foot traffic per dayshift hour significantly decreased from 221 people to 160 people (28%, p < .001), and non-A&E related foot traffic decreased from 81.4% to 36.3% (45% decrease, p < .001). One hundred percent of the A&E patients have been formally triaged since the implementation of the newly established triage system. Our project used quality improvement principles to reduce the number of patients boarding in the hallways and to decrease unnecessary foot traffic in the A&E department with little investment from the hospital. Key success factors included a collaborative multidisciplinary project team, strong internal champions, data-driven analysis, evidence-based interventions, senior leadership support, and rapid application of initial implementation learnings. Results to date show the application of quality improvement principles can help hospitals in resource-limited settings improve quality of care at relatively low cost.

scholarly journals Methodological Characteristics of Clinical Trials Supporting the Marketing Authorisation of Advanced Therapies in the European Union

2021 ◽  
Vol 12 ◽  
Author(s):  
Carolina Iglesias-Lopez ◽  
Antònia Agustí ◽  
Antonio Vallano ◽  
Merce Obach
Keyword(s):  
European Union ◽  
Clinical Trials ◽  
Added Value ◽  
Life Cycle Approach ◽  
The European Union ◽  
Open Label ◽  
Advanced Therapy ◽  
Advanced Therapies ◽  
Number Of Patients ◽  
The Eu

Several advanced therapy medicinal products (ATMPs) have been approved in the European Union (EU). The aim of this study is to analyse the methodological features of the clinical trials (CT) that supported the marketing authorization (MA) of the approved ATMPs in the EU. A systematic review of the characteristics of pivotal CT of ATMPs approved in the EU until January 31st, 2021 was carried out. A total of 17 ATMPs were approved and 23 CT were conducted to support the MA (median, 1, range, 1–3). Of those studies, 8 (34.78%) were non-controlled and 7 (30.43%) used historical controls. Only 7 (30.4%) were placebo or active-controlled studies. Among all CT, 21 (91.3%) were open-label and 13 (56.52%) had a single-arm design. To evaluate the primary endpoint, 18 (78.26%) studies used an intermediate and single variable. The median (IQR) number of patients enrolled in the studies was 75 (22–118). To date, ATMPs’ approval in the EU is mainly supported by uncontrolled, single-arm pivotal CT. Although there is a trend toward an adaptive or a life cycle approach, a switch to more robust clinical trial designs is expected to better define the benefit and the therapeutic added value of ATMPs.

Road Traffic Accident Related Morbidity as Seen in an Accident and Emergency Department

1981 ◽  
Vol 26 (2) ◽  
pp. 121-124 ◽  
Author(s):  
D. J. Galloway ◽  
A. R. Patel
Keyword(s):  
Emergency Department ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Young Male ◽  
Education Programme ◽  
Small Sample ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
Serious Injuries

This paper describes some of the findings of a prospective study of victims of road traffic accidents arriving at the Western Infirmary's Accident and Emergency Department over a period of 12 months. More than half the accidents occurred during leisure hours thus likely to stretch the resources of the hospital services. More than a third of the total number of patients were young male drivers. Serious injuries were significantly more often sustained among pedestrians who were often older. Victims of motor-cycle accidents less often escaped serious injuries. Blood ethanol studies on a small sample suggested that male pedestrians were often highly intoxicated. A public health education programme is regarded as a primary measure in preventing a large proportion of serious morbidity and mortality especially amongst pedestrians.

scholarly journals Awarded innovative and educational good practices against chronic pain across Europe

2021 ◽  
Vol 4 (1) ◽  
pp. 171-176
Author(s):  
Mariano Votta ◽  
◽  
Daniela Quaggia ◽  
Gianluca Bruzzese ◽  
Maira Cardillo ◽  
...  
Keyword(s):  
Chronic Pain ◽  
European Union ◽  
Professional Education ◽  
Healthcare Professionals ◽  
Active Citizenship ◽  
The European Union ◽  
Research Project ◽  
Good Practices ◽  
The Third ◽  
Patient Organizations

In continuation with the second edition of the research project “European Civic Prize on Chronic Pain – Collecting Good Practices”, the third edition of the initiative led by Active Citizenship Network, whose term has spanned from 2020-2021, has recently selected several good practices in the fight against chronic pain in the European Union. This year’s edition of the Prize has been extremely significant, as it has taken place in the midst of the Covid-19 pandemic, and a diverse approach has been taken in the collection and implementation of good practices. The project has included practices stemming from healthcare professionals, institutions, civic and patient organizations, and other advocative entities for patients in Europe. This article will focus on two of the winning good practices that have been selected by the Jury of experts and will examine initiatives related to Professional Education and Innovation.

scholarly journals Comparative Analysis of Medical Workers

2020 ◽  
Author(s):  
Marija Lugonjić
Keyword(s):  
European Union ◽  
Medical Education ◽  
Comparative Analysis ◽  
Russian Federation ◽  
Healthcare Professionals ◽  
Continuous Medical Education ◽  
Minimum Condition ◽  
The European Union ◽  
Institutional Settings ◽  
Official Gazette

Continuous Medical Education (CME) is becoming a minimum condition for adapting to today's changes and achieving success in professional and personal fields.The aim of this paper is a comparative analysis of CME in Serbia, the European Union, and the United Kingdom; US, Russian Federation and Iran. The aim of this comparative study was to assess the main countryspecific institutional settings applied by governments. Methods: A common scheme of analysis was applied to investigate the following variables: CME institutional framework; benefits and/or penalties to participants; types of CME activities and system of credits; accreditation of CME providers and events; CME funding and sponsorship. The analysis involved reviewing the literature on CME policy. Results: The US system has clear KME boundaries because it is implemented solely by credentialed institutions that organize dedicated meetings with the clear purpose of educating medical professionals.The European Union has not yet been able to reconcile the differences it has inherited from its members. Only "general" conditions are defined. Continuing medical education cannot be arbitrary, like any other organizational process. Everything has to be controlled in advance. Education in the Russian Federation is regulated by the law, Art. 2 and must be viewed as a whole. Doctors and healthcare professionals and their associates earn points through accredited continuing education programs for obtaining and renewing licenses of the Serbian Medical Chamber and KMSZTS - Chamber of Nurses and Health Technicians of Serbia. The Ordinance establishes the conditions for issuing, renewing and revoking the license for independent work, ie. License to Healthcare Professionals. (RS Official Gazette 102/2015) Conclusin: This comparative exercise provides an overview of the CME policies adopted by analyzed countries to regulate both demand and supply. The substantial variability in the organization and accreditation of schemes indicates that much could be done to improve effectiveness. Although further analysis is needed to assess the results of these policies in practice, lessons drawn from this study may help clarify the weaknesses and strengths of single domestic policies in the perspective.

Healthcare Fraud and Abuse in Europe

2020 ◽  
Author(s):  
Tracey A. Elliott
Keyword(s):  
European Union ◽  
Healthcare Professionals ◽  
Healthcare Systems ◽  
Nordic Countries ◽  
European Countries ◽  
Significant Problem ◽  
The European Union ◽  
Transparency International ◽  
European Approach ◽  
The Uk

This chapter explores the significant problem of healthcare fraud in Europe, which in the UK alone is estimated at £1.27 billion a year or more than 30% of the European Union healthcare budgets. It emphasizes the difficulties of identifying the predominant “European approach” on the ethical, definitional, and operational challenges that make healthcare fraud difficult to define, identify, police, and prevent. It also describes different healthcare fraud problems in European countries that vary in historical, cultural, and political circumstances. This chapter discusses the significance of how European states manage the financing of their healthcare systems and payment of healthcare professionals as it affects the forms of abusive conduct that might occur. It also mentions the UK, Ireland, Italy, Spain, Portugal, and the Nordic Countries as states vulnerable to procurement corruption as stated by Transparency International.

scholarly journals The Investigation on the Burden of Neurology Residents to Manage the Patient who Received Thrombolytic Treatment in the Emergency Department with Hyperacute Stroke

2021 ◽  
Vol 39 (4) ◽  
pp. 305-311
Author(s):  
Hyun Joon Lee ◽  
Dong Hoon Shin ◽  
Kwang Ik Yang ◽  
Im-Seok Koh ◽  
Kyung Bok Lee ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Stroke ◽  
Teaching Hospitals ◽  
Stroke Patients ◽  
Stroke Incidence ◽  
Average Hospital ◽  
Stroke Treatment ◽  
Hyperacute Stroke ◽  
Number Of Patients ◽  
Hospital Beds

Background: Because Korea is the fastest aging country, the stroke incidence is increasing rapidly. We investigate the trend of the number of patients with acute stroke in recent years and estimate the burden of the neurologist to treat the acute stroke patient visited the emergency department.Methods: We requested a questionnaire survey to all teaching hospitals on the number of hospital beds, the number of stroke patients who visited the emergency department, the number of stroke patients in charge of the neurologist, and the number of days on duty of residents from 2016 to 2019.Results: Of 69 teaching hospitals, 41 hospitals answered the survey. The average hospital beds per hospital were increased annually from 909 to 916. The average patients who visited the emergency department with stroke and were in charged to neurologists were rapidly increased from 799 to 867 per hospital. In particular, the number of patients with hyperacute cerebral infarction requiring the thrombolytic administration or mechanical thrombectomy were rapidly increased from 105 to 131. On the other hand, the average number of residents per hospital was decreased from 5.1 to 4.8. Therefore, the days on duty per resident were increased from 74 to 77.Conclusions: The number of acute stroke patients, especially, hyperacute stroke required the rapid cooperation and high labor were increasing rapidly in recent years. However, because the number of residents were decreased, the burden was increasing. To improve the quality of acute stroke treatment, it is necessary to increase the number of residents.

scholarly journals The Catalan Conflict in Spain: Consequences for the European Union

2019 ◽  
Vol 2018 (4) ◽  
pp. 13-18 ◽  
Author(s):  
Татьяна Вербицкая ◽  
Tatyana Verbitskaya ◽  
Полина Гилева ◽  
Polina Gileva ◽  
Федор Золотарев ◽  
...  
Keyword(s):  
European Union ◽  
Structural Analysis ◽  
Empirical Research ◽  
Political System ◽  
Comparative Method ◽  
Systemic Approach ◽  
The European Union ◽  
Scientific Methods ◽  
News Reports ◽  
Video Recordings

The present paper identifies the specific features of the conflict between Madrid and Catalonia and its significance for the European Union. The Catalan conflict serves here as an example of the regionalism processes in the European Union. The author defines the conflict as postmodern, which determines the novelty of the research. The research employed integrated scientific methods. The comparative method was used to compare the economic, social, cultural, and political positions and aspects of Catalonia and Spain; the method of actualization was used to describe the situation taking into account the specifics of the region; the method of structural analysis was used to study the content of the conflict. The authors applied the systemic approach since the structure of the Spanish political system is extremely complex. Analytical expert articles, news reports, and video recordings were used as an empirical research base. As a result, some features of the conflict in the postmodern world were revealed and exemplified by the Catalan crisis.

scholarly journals Implementing the new European Regulations on medical devices—clinical responsibilities for evidence-based practice: a report from the Regulatory Affairs Committee of the European Society of Cardiology

2020 ◽  
Vol 41 (27) ◽  
pp. 2589-2596 ◽  
Author(s):  
Alan G Fraser ◽  
Robert A Byrne ◽  
Josef Kautzner ◽  
Eric G Butchart ◽  
Piotr Szymański ◽  
...  
Keyword(s):  
European Union ◽  
High Risk ◽  
Medical Devices ◽  
European Society ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
The European Union ◽  
Regulatory Affairs ◽  
Technical Specifications ◽  
European Society Of Cardiology

Abstract The new European Union (EU) law governing the regulatory approval of medical devices that entered into force in May 2017 will now take effect from 26 May 2021. Here, we consider how it will change daily practice for cardiologists, cardiac surgeons, and healthcare professionals. Clinical evidence for any high-risk device must be reported by the manufacturer in a Summary of Safety and Clinical Performance (SSCP) that will be publicly available in the European Union Database on Medical Devices (Eudamed) maintained by the European Commission; this will facilitate evidence-based choices of which devices to recommend. Hospitals must record all device implantations, and each high-risk device will be trackable by Unique Device Identification (UDI). Important new roles are envisaged for clinicians, scientists, and engineers in EU Expert Panels—in particular to scrutinize clinical data submitted by manufacturers for certain high-risk devices and the evaluations of that data made by notified bodies. They will advise manufacturers on the design of their clinical studies and recommend to regulators when new technical specifications or guidance are needed. Physicians should support post-market surveillance by reporting adverse events and by contributing to comprehensive medical device registries. A second law on In Vitro Diagnostic Medical Devices will take effect from 2022. We encourage all healthcare professionals to contribute proactively to these new systems, in order to enhance the efficacy and safety of high-risk devices and to promote equitable access to effective innovations. The European Society of Cardiology will continue to advise EU regulators on appropriate clinical evaluation of high-risk devices.

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