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. 2010 Apr;107(15):261-7.
doi: 10.3238/arztebl.2010.0261. Epub 2010 Apr 16.

Numerical parameters and quality indicators in a medical emergency department

Harald Dormann  1 , Katharina Diesch, Thomas Ganslandt, Eckhardt G Hahn
Affiliations

Numerical parameters and quality indicators in a medical emergency department

Harald Dormann et al. Dtsch Arztebl Int. 2010 Apr.

Abstract

Background: Despite calls for improved quality and efficiency in medical emergency departments, there exist hardly any quality indicators, and no methods of calculating efficiency have been published to date. The present study illustrates a means of presenting numerical parameters of a medical emergency department and of identifying potential quality indicators.

Method: Over a period of 12 months, all patient contacts of the medical emergency department in the University hospital of Erlangen were analyzed with respect to patient flow, diagnoses, and treatment units. The diagnostic agreement (DA) parameter was calculated from a systematic comparison of admitting and discharge diagnoses, and diagnostic efficiency (DE) was defined and calculated as the quotient of DA x100 divided by the length of stay in the emergency department.

Results: Among the 6683 patients treated, 64.6% underwent further in-hospital care. The diagnostic spectrum of the outpatients differed markedly from that of the inpatients. Patients with diseases of the heart, gastrointestinal tract, and lungs were usually admitted to the hospital for further treatment. Patient contacts had a characteristic circadian and weekly rhythmic pattern. For the overall patient collective, the DA was 71%. The mean length of stay in the emergency department was 116 minutes, and the DE was therefore 0.61/min. The DA was highest (92%) among patients with atrial flutter or fibrillation, while the DE was highest (0.85/min) among patients with acute myocardial infarction. 14% of the patients required further treatment in intensive care.

Conclusion: Numerical parameters and quality indicators for a hospital emergency department can be presented in transparent fashion. DA and DE can be used as parameters for diagnosis-related and intradepartmental quality assessment.

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Figures

Figure 1
Figure 1
Formula for calculating the diagnostic efficiency (DE)
Figure 2
Figure 2
Patient flow statistics—Daily and weekly rhythm of patient contact with the emergency department (6683 patients)
See this image and copyright information in PMC

Comment in

  • Evaluation of medical emergency rooms.
    Werdan K. Werdan K. Dtsch Arztebl Int. 2010 Apr;107(15):259-60. doi: 10.3238/arztebl.2010.0259. Epub 2010 Apr 16. Dtsch Arztebl Int. 2010. PMID: 20458366 Free PMC article. No abstract available.
  • A multitude of non-specific complaints.
    Fischer MK, Konitzer M. Fischer MK, et al. Dtsch Arztebl Int. 2010 Nov;107(45):794; author reply 794-5. doi: 10.3238/arztebl.2010.0794a. Epub 2010 Nov 12. Dtsch Arztebl Int. 2010. PMID: 21124698 Free PMC article. No abstract available.

References

    1. Fleischmann T. Wege aus der Notaufnahme - wann ambulant, stationär oder intensiv? - Grundlage ist eine adäquate Risiko stratifikation. Klinikarzt. 2009;38:26–30.
    1. Burchardi C, Angstwurm M, Endres S. Spectrum of diagnoses in an internal medicine emergency unit. Internist. 2001;42:1462–1464. - PubMed
    1. Koeniger R, Räwer H, Widmer R, Schepp W. Präklinik mit integrierter Aufnahmestation. Dtsch Arztebl. 2006;103(42):2770–2773.
    1. Nowak B, Strasheim R, Victor A, Voigtländer T, Schmermund A, Fach WA. Neue Wege in der kardiologischen Notfallversorgung - „Chest pain unit“ im Belegarztsystem. Dtsch Arztebl. 2007;104(27):1988–1994.
    1. Stürmer KM. Gemeinsame Stellungnahme der Deutschen Gesellschaft für Chirurgie (DGCH) und der Deutschen Gesellschaft für Innere Medizin (DGIM) Medizinische Klinik. 2007;102:180–181.

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