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Published on: November 9, 2016
[Pediatric practice in public emergency services and factors affecting care]
Egléa Maria da Cunha Melo1, Ada Avila Assunção, Roberto Assis Ferreira
1Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, MG 30310, Brazil. egleamelo@uol.com.br
Insights
Pediatricians in public emergency services face challenges due to a flawed referral system, leading to overcrowding and time pressure. They develop informal strategies to maintain quality pediatric care despite these issues.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Management
- Qualitative Research Methods
Context:
- Public emergency services face significant challenges in pediatric care delivery.
- The study focuses on the material and organizational conditions impacting pediatricians' work.
- Analysis includes group interviews, direct observation, and documental research.
Purpose:
- To identify factors affecting the quality of pediatric care in emergency settings.
- To understand the work environment of pediatricians in public emergency services.
- To explore the impact of systemic issues on clinical practice.
Summary:
- A qualitative study examined pediatricians' work in a public emergency unit.
- Findings reveal a precarious referral system contributes to high demand and patient agglomeration.
- Physicians employ informal strategies to ensure quality pediatric care amidst these pressures.
Impact:
- Highlights systemic deficiencies in healthcare referral networks.
- Underscores the impact of patient flow and time pressure on pediatric care quality.
- Identifies physician-led adaptive strategies for maintaining care standards.
Abstract:
This qualitative empirical study discusses the material and organizational conditions of work by pediatricians in a public emergency service, with the aim of identifying factors that affect care. The work was studied using group interviews and direct observation in the emergency unit. The results were compared with statistical and historical data from documental research. Forty-four pediatricians from seven teams were interviewed, and seven of the pediatricians were observed while on duty. The precarious referral and counter-referral system was a determinant factor leading to the heavy demand on the emergency unit. Agglomeration of patients and families at the entrance to the emergency service led to time pressure and interfered directly in the pediatric care. The study identified informal strategies devised and implemented by these physicians in attempts to guarantee the quality of care in keeping with pediatric principles.
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