爱荷华州的急救部门缺乏经过董事会认证的急救医生:一个全面的全州急救部门劳动力研究
Natalie Boone1, Timothy Samuelson1, Nicholas Mohr2
1Des Moines University, West Des Moines, Iowa, USA.
概括
爱荷华州的急救部门 (EDs) 主要使用非董事会认证的急救医生 (EPs),农村关键入口医院 (CAHs) 显示出严重的短缺. 尽管紧急医疗 (EM) 住院职位的全国增加,但农村ED人员数量基本保持不变,这表明这些地区持续需要EP.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健工作人员分析
- 农村卫生 农村卫生
背景情况:
- 国家预测显示,到2030年,急诊医生 (EP) 可能会出现余.
- 之前的研究强调了急诊室 (ED) 人员的显著变化和缺乏EP候选人.
- 紧急医疗 (EM) 住院职位的增加促使人们对爱荷华州目前的ED人员配置趋势进行调查.
研究的目的:
- 自2013年以来,评估爱荷华州ED医生人员的变化,特别是董事会认证的EP的存在.
- 为了识别与目前的人员配置模式相关的爱荷华州ED的操作差异.
- 为其他主要农村国家提供有关农村ED人事挑战的见解.
主要方法:
- 对非联邦爱荷华州的ED进行电子和电话调查,从领导层代表那里收集数据.
- 使用结构化数据收集工具,包括客观的人员数据和关于人员合理性和操作的利克尔特式问题.
- 将当前发现与2013年类似的爱荷华州ED工作人员研究进行了比较,从美国医院协会获得了医院特征.
主要成果:
- 在116个爱荷华州的ED中,有113个 (97%) 回答;其中17%的员工是专属EP的,66%是混合的,17%是非EP的.
- 临界接入医院 (CAHs) 仅由 EP 配备人员 (4%对非CAHs的42%).
- 聘用非EP的主要原因是他们的可用性 (70%),而EP则是因为护理质量而聘用 (58%). 人员配置模式在很大程度上与2013年相似.
结论:
- 爱荷华州的ED仍然主要由非EP员工组成,过去十年来观察到的变化很小.
- 农村CAH和非CAH之间在EP人员配置方面存在很大的差异,CAH经历了显著的短缺.
- 增加的EM居住职位并没有有效地透到农村爱荷华州的ED,这凸显了这些服务不足地区对EP人员的持续需求和愿望.
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