Recherchez au-delà des murs de l'unité d'urgence pour les facteurs de retards dans l'unité d'urgence : modélisation des associations avec l'hôpital et les soins post-aigus et exploration d'interventions prometteuses


Beste Kucukyazici

Université McGill


Domaine : services de santé

Recherches sur l'urgence et le coninuum des soins - volet 1

Concours 2015-2016

In order to assist policy makers and hospital administrators, we propose a comprehensive and jurisdictional approach for studying the problems impacting the flow of ED patients through the continuum of care, including hospital acute and post-acute care. To this end, first we will quantify the severity of all delays in ED patient flow and define their relative importance. Then we will examine whether these delays vary significantly for different groups of patients and the relationships between these delays and patient outcomes. Then we will investigate the factors associated with these delays by identifying (i) ED related factors, (ii) Hospital related factors, and (iii) Post-acute care related factors.

Finally, we will explore the potential impact of a comprehensive set of interventions, focused on reducing these delays, and ED overcrowding accordingly by developing a simulation based quantitative decision tool. Our methodology comprises three major phases: 1) conceptual model and hypothesis-testing, 2) quantitative decision tool, and 3) development of recommendations. For Phase 1, by using the ED and hospital clinical information databases of 41 Quebec EDs that have been using full or partial versions of MedGPS Software (by MediaMed Technologies) we will record the patient, ED, hospital related variables of all visits for the last 2 years. In order to gather data about the organizational factors of the EDs and the hospitals we will survey key informants of EDs and the hospitals. In Phase 2, we will develop a simulation based optimization tool that will model the flow of patient in order to test the interventions.