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Competing values of emergency department performance: balancing multiple stakeholder perspectives
Deborah Tregunno1, G Ross Baker, Jan Barnsley
1Canadian Health Services Research Foundation Post Doctoral Fellow, University of Toronto, Ontario, Canada.
Health Services Research
|July 3, 2004
Summary
Emergency department (ED) performance interests vary significantly among stakeholders. A balanced assessment requires including community-based perspectives, often overlooked in ED performance evaluations.
Area of Science:
- Healthcare Management
- Performance Measurement
- Emergency Medicine
Background:
- Emergency departments (EDs) face complex management and delivery challenges.
- Understanding diverse stakeholder perspectives is crucial for effective ED performance evaluation.
Purpose of the Study:
- To identify the performance interests of various ED stakeholders.
- To develop a comprehensive ED performance framework and indicators reflecting these interests.
Main Methods:
- Survey of 1,100 ED stakeholders (physicians, nurses, managers, home care, prehospital personnel) in Ontario, Canada.
- Analysis of responses regarding 104 potential ED performance indicators using descriptive and inferential statistics.
Main Results:
- Stakeholders prioritize indicators relevant to their specific roles and capacities.
- Significant differences in performance interests exist between hospital-based and non-hospital-based stakeholders.
- Physicians rated the importance of ED performance measures lower than other groups.
Conclusions:
- ED performance interests are heterogeneous, necessitating a multi-stakeholder approach for balanced assessments.
- Community-based stakeholders offer unique insights into ED performance, particularly concerning external factors and care continuity.
- Excluding non-hospital stakeholders leads to incomplete evaluations of ED performance.