title: Planning emergency patients: An attempt to change the nature of the emergency department.
abstract: Throughout the day, arrivals of patients at the emergency department (ED) are unannounced, unpredictable and fully determined by chance. Healthcare professionals in the ED naturally react as quickly as possible when patients arrive. We wondered whether they could somehow act in advance. We introduced a planning system that enabled the ED to regulate arrival times of emergency patients referred by the general practitioner. The system established direct contact between the general practitioner and the ED at the press of a button. As a result, the ED was able to schedule a fraction of its unpredictable patient demand. Implementation of the system at large was unsuccessful however. Changing the nature of the ED turned out to be far more difficult than expected. In our opinion, successfully planning emergency patients requires that the ED has full control over the referral process, and that scheduled patients are treated in a separate, undisturbed care process.
authors.affiliation: Department of Operations, Organisation and Human Resources, Faculty of Business, Public Administration and Technology, University of Twente, Enschede, The Netherlands. r.w.rosmulder@utwente.nl
authors.forename: Remco
authors.initials: R
authors.lastname: Rosmulder
authors.forename: Koos
authors.initials: K
authors.lastname: Krabbendam
authors.forename: Jan S K
authors.initials: JS
authors.lastname: Luitse
mesh_terms: D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D002272:Carcinoembryonic Antigen; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005194:Family Practice / Q000458:organization & administration*; D006302:Health Services Research; D006754:Hospital Restructuring / Q000458:organization & administration*; D006785:Hospitals, University / Q000458:organization & administration; D006786:Hospitals, Urban / Q000458:organization & administration; D006801:Humans; D007373:Interinstitutional Relations; D008505:Medical Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D017146:Models, Organizational; D009426:Netherlands; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D009936:Organizational Innovation; D010865:Pilot Projects; D010934:Planning Techniques; D016730:Program Development; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D013997:Time Factors
chemical_list: D002272:Carcinoembryonic Antigen