低および高需要下における救急外来の転帰決定プロセスを特徴づけるワークシステムアプローチ
Rachel A Rutkowski1, Michael S Pulia2, Megan E Salwei3
1Department of Industrial and Systems Engineering, University of Wisconsin (UW)-Madison, USA.
Abstract:
Emergency department (ED) clinical decision-making, specifically for transfer or disposition decisions, has been challenging to characterize. The purpose of this descriptive study is to identify the work system elements that influence the ED disposition decision-making process and to identify those work system elements that vary under low and high demands. We conducted a work systems analysis of 20 contextual inquiry-based ED visit observations and 18 semi-structured interviews with ED clinicians. Results identified work system elements not previously characterized (i.e., physical environment) and revealed that a subset of elements within the ED work system vary with demand. To fully elucidate the meaning and effect of these differences, we must develop a systematic approach to eliciting the influence each work system element has on disposition decision-making process performance.
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