Related Experiment Video
Updated: Jun 8, 2026
08:13
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Integrated care in the emergency department: a complex adaptive systems perspective.
Peter Nugus1, Katherine Carroll, David G Hewett
1University of New South Wales, Sydney, NSW, Australia. p.nugus@unsw.edu.au
Social Science & Medicine (1982)
|October 16, 2010
Summary
Emergency clinicians manage complex patient care by navigating shifting boundaries between departments. A complex adaptive systems (CAS) perspective offers a better framework than linear models for understanding integrated care in the Emergency Department (ED).
Area of Science:
- Healthcare Management
- Systems Science
- Medical Sociology
Background:
- Emergency Departments (EDs) face challenges integrating patient care across various hospital units.
- Traditional models view patient journeys linearly as
Purpose of the Study:
- To conceptualize integrated care in the ED using a Complex Adaptive Systems (CAS) perspective.
- To analyze the dynamic boundary-work performed by emergency clinicians.
Main Methods:
- One year of ethnographic research in two tertiary referral hospital EDs.
- Combined participant observation and semi-structured interviews.
Main Results:
- A CAS perspective effectively analyzes integrated care by focusing on service linkages and communication.
- Categorization, diagnosis, and discharge processes involve complex negotiations across boundaries.
- Linear models inadequately explain the efficient management of high-need patients in EDs.
Conclusions:
- Integrated care in the ED is better understood as managing patient trajectories within dynamic, porous boundaries.
- A CAS approach provides a more accurate framework for analyzing ED patient flow and interdepartmental collaboration.
Related Concept Videos
01:20Integrated Healthcare System
An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
01:15Methods of Documentation VI: Case Management Model
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
For example, a patient with a chronic illness...
01:27Nursing Clinical Information System
Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:21Interdisciplinary Care: The Health Care Team-I
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution itself.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution itself.
01:28Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
01:18Interdisciplinary Care: The Health Care Team-II
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care. Here are a few more healthcare professionals.
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...