The organization of Danish emergency departments

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The organization of Danish emergency departments. / Moellekaer, Anders; Duvald, Iben; Obel, Borge; Madsen, Bo; Eskildsen, Jacob; Kirkegaard, Hans.

I: European Journal of Emergency Medicine, 28.06.2018.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{de62a6576bcf463b8e32b4af534b9151,
title = "The organization of Danish emergency departments",
abstract = "INTRODUCTION: Twenty-one new Danish emergency departments (EDs) were established following a 2007 policy reform that included ED autonomy to self-organize. The aim of this study was to describe the organization of the 21 departments and their organizational challenges.PARTICIPANTS AND METHODS: We used a qualitative design based on COREQ guidelines. All 21 EDs participated, and 123 semi-structured interviews with hospital and ED leaders, physicians, nurses, and secretaries were performed between 2013 and 2015. We used the framework matrix method to investigate the ED goals, setting, structure, staff, task coordination, and incentive structure.RESULTS: We identified three generic models (virtual, hybrid, and independent). All had goals of high quality of care and high efficiency. The virtual model was staffed by junior physicians and tasks were coordinated by other departments. The hybrid model was staffed by junior physicians and senior physicians according to other departments and the ED. The ED coordinated all activities. The independent model was staffed by junior physicians and senior physicians, and activities were coordinated by the ED. Of the EDs, 19 utilized different organizational models at different times during a 24-h period and on weekdays and weekends. The main challenge of the virtual and hybrid models was high dependency on other departments. The main challenge of the independent model was establishing a high level of quality of emergency medicine.DISCUSSION AND CONCLUSION: We identified three organizational ED models (virtual, hybrid, and independent). Nineteen EDs used more than one organizational model depending on the time of day or day of the week.",
author = "Anders Moellekaer and Iben Duvald and Borge Obel and Bo Madsen and Jacob Eskildsen and Hans Kirkegaard",
year = "2018",
month = "6",
day = "28",
doi = "10.1097/MEJ.0000000000000554",
language = "English",
journal = "European Journal of Emergency Medicine",
issn = "0969-9546",
publisher = "Lippincott Williams & Wilkins, Ltd.",

}

RIS

TY - JOUR

T1 - The organization of Danish emergency departments

AU - Moellekaer, Anders

AU - Duvald, Iben

AU - Obel, Borge

AU - Madsen, Bo

AU - Eskildsen, Jacob

AU - Kirkegaard, Hans

PY - 2018/6/28

Y1 - 2018/6/28

N2 - INTRODUCTION: Twenty-one new Danish emergency departments (EDs) were established following a 2007 policy reform that included ED autonomy to self-organize. The aim of this study was to describe the organization of the 21 departments and their organizational challenges.PARTICIPANTS AND METHODS: We used a qualitative design based on COREQ guidelines. All 21 EDs participated, and 123 semi-structured interviews with hospital and ED leaders, physicians, nurses, and secretaries were performed between 2013 and 2015. We used the framework matrix method to investigate the ED goals, setting, structure, staff, task coordination, and incentive structure.RESULTS: We identified three generic models (virtual, hybrid, and independent). All had goals of high quality of care and high efficiency. The virtual model was staffed by junior physicians and tasks were coordinated by other departments. The hybrid model was staffed by junior physicians and senior physicians according to other departments and the ED. The ED coordinated all activities. The independent model was staffed by junior physicians and senior physicians, and activities were coordinated by the ED. Of the EDs, 19 utilized different organizational models at different times during a 24-h period and on weekdays and weekends. The main challenge of the virtual and hybrid models was high dependency on other departments. The main challenge of the independent model was establishing a high level of quality of emergency medicine.DISCUSSION AND CONCLUSION: We identified three organizational ED models (virtual, hybrid, and independent). Nineteen EDs used more than one organizational model depending on the time of day or day of the week.

AB - INTRODUCTION: Twenty-one new Danish emergency departments (EDs) were established following a 2007 policy reform that included ED autonomy to self-organize. The aim of this study was to describe the organization of the 21 departments and their organizational challenges.PARTICIPANTS AND METHODS: We used a qualitative design based on COREQ guidelines. All 21 EDs participated, and 123 semi-structured interviews with hospital and ED leaders, physicians, nurses, and secretaries were performed between 2013 and 2015. We used the framework matrix method to investigate the ED goals, setting, structure, staff, task coordination, and incentive structure.RESULTS: We identified three generic models (virtual, hybrid, and independent). All had goals of high quality of care and high efficiency. The virtual model was staffed by junior physicians and tasks were coordinated by other departments. The hybrid model was staffed by junior physicians and senior physicians according to other departments and the ED. The ED coordinated all activities. The independent model was staffed by junior physicians and senior physicians, and activities were coordinated by the ED. Of the EDs, 19 utilized different organizational models at different times during a 24-h period and on weekdays and weekends. The main challenge of the virtual and hybrid models was high dependency on other departments. The main challenge of the independent model was establishing a high level of quality of emergency medicine.DISCUSSION AND CONCLUSION: We identified three organizational ED models (virtual, hybrid, and independent). Nineteen EDs used more than one organizational model depending on the time of day or day of the week.

U2 - 10.1097/MEJ.0000000000000554

DO - 10.1097/MEJ.0000000000000554

M3 - Journal article

JO - European Journal of Emergency Medicine

T2 - European Journal of Emergency Medicine

JF - European Journal of Emergency Medicine

SN - 0969-9546

ER -