Why do patients who are triaged as low-acuity visit the emergency department? – A Polish perspective

IF 1.8 4区 医学 Q2 NURSING International Emergency Nursing Pub Date : 2024-08-24 DOI:10.1016/j.ienj.2024.101506
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Abstract

Background

Emergency departments (EDs) worldwide are dealing with overcrowding, system fragmentation, and coordination problems, which impact patient wait times, staff job satisfaction, and patient outcomes. Inappropriate ED visits, particularly those for low acuity conditions, exacerbate these challenges. However, the motivations behind these visits are poorly understood, with limited data from the patient perspective. This study investigated patient-reported motives behind ED visits triaged as low acuity in Poznan, Poland, to propose health care system flow enhancements.

Material and methods

A cross-sectional survey and retrospective chart review were conducted in the ED of the Hipolit Cegielski Medical Center in Poznań, Poland, over three months in 2022–23. Patients who were triaged to have low acuity conditions were invited to participate in the survey. The data collected through the questionnaire included patient and ED visit characteristics. Additional information on the visits was extracted from the patient charts.

Main results

This study involved 293 patients who underwent low-acuity triage. Among them, 58 % were deemed to have conditions that could have been treated in primary care. Most of the patients (74 %) visited the ED of their own volition due to concerns about their health. Other reasons for ED attendance were challenges accessing primary care or a specialist clinic (11 %), system navigation problems (5 %), or a lack of trust in their primary care provider (2 %).

Conclusions

This study showed that of the patients surveyed, the majority had conditions that could have been treated outside of the ED setting. We recommend prioritizing education, particularly among younger adults, to increase awareness about nonurgent care options while improving health care policies.

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为什么被分流为低危症的患者会到急诊科就诊?- 波兰人的视角。
背景:全世界的急诊科(ED)都面临着过度拥挤、系统分散和协调问题,这些问题影响了患者的等待时间、工作人员的工作满意度和患者的治疗效果。不适当的急诊室就诊,尤其是那些病情不严重的患者,加剧了这些挑战。然而,人们对这些就诊背后的动机却知之甚少,从患者角度获得的数据也很有限。本研究调查了在波兰波兹南被分流为低危急值的急诊室就诊患者报告的就诊动机,以提出医疗系统流程改进建议:2022-23 年间,在波兰波兹南 Hipolit Cegielski 医疗中心的急诊室进行了为期三个月的横断面调查和回顾性病历审查。被分流为低急性病的患者被邀请参与调查。调查问卷收集的数据包括患者和急诊室就诊特征。从患者病历中提取了就诊的其他信息:这项研究涉及 293 名接受低急诊分诊的患者。其中,58%的患者被认为患有可在初级医疗机构接受治疗的疾病。大多数患者(74%)因担心自己的健康状况而主动前往急诊室就诊。到急诊室就诊的其他原因包括:在初级保健或专科门诊就医时遇到困难(11%)、系统导航问题(5%)或对初级保健提供者缺乏信任(2%):这项研究表明,在接受调查的患者中,大多数人的病情本可以在急诊室以外的地方得到治疗。我们建议在改善医疗保健政策的同时,优先开展教育,尤其是在年轻人中开展教育,以提高他们对非紧急护理选择的认识。
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来源期刊
CiteScore
3.20
自引率
11.10%
发文量
85
期刊介绍: International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.
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