Quality in emergency departments: a study on 3,285,440 admissions.
BACKGROUND
A multi-centre study has been conducted, during 2005, by means of a questionnaire posted on the Italian Society of Emergency Medicine (SIMEU) web page. Our intention was to carry out an organisational and functional analysis of Italian Emergency Departments (ED) in order to pick out some macro-indicators of the activities performed. Participation was good, in that 69 ED (3,285,440 admissions to emergency services) responded to the questionnaire.


METHODS
The study was based on 18 questions: 3 regarding the personnel of the ED, 2 regarding organisational and functional aspects, 5 on the activity of the ED, 7 on triage and 1 on the assessment of the quality perceived by the users of the ED.


CONCLUSIONS
The replies revealed that 91.30% of the ED were equipped with data-processing software, which, in 96.83% of cases, tracked the entire itinerary of the patient. About 48,000 patients/year used the ED: 76.72% were discharged and 18.31% were hospitalised. Observation Units were active in 81.16% of the ED examined. Triage programmes were in place in 92.75% of ED: in 75.81% of these, triage was performed throughout the entire itinerary of the patient; in 16.13% it was performed only symptom-based, and in 8.06% only on-call. Of the patients arriving at the ED, 24.19% were assigned a non-urgent triage code, 60.01% a urgent code, 14.30% a emergent code and 1.49% a life-threatening code. Waiting times were: 52.39 min for non-urgent patients, 40.26 min for urgent, 12.08 for emergent, and 1.19 for life-threatening patients.
Sartini
M
M
Dept. Health Sciences, University of Genoa, Italy. msartini@unige.it
Cremonesi
P
P
Tamagno
R
R
Cristina
M L
ML
Orlando
P
P
Vandelli
A
A
Carinci
A
A
Caruso
A
A
Grotti
A
A
Iacovella
A
A
La Brocca
A
A
Mangioncalda
A
A
Longanesi
A M
AM
Susi
B
B
Barletta
C
C
Braglia
D
D
Coen
D
D
Tazza
D
D
Gottardi
E
E
Palego
E
E
Urbano
E
E
Bar
F
F
Bussani
F
F
De Giorgi
F
F
Esposito
F
F
Fabi
F
F
Lotti
F
F
Miglio
F
F
Moscariello
F
F
Pertoldi
F
F
Sardella
F
F
Tosato
F
F
Abregal
G
G
Baldi
G
G
Carbone
G
G
Cerqua
G
G
Giagnorio
G
G
Pia
G
G
Piazza
G
G
Tedesco
G
G
Sallustio
G F
GF
Morana
I
I
Beringheli
L
L
Jannotti
L
L
Spinsi
L
L
Zulli
L
L
Cavazza
M
M
De Simone
M
M
Galletti
M
M
Gioffrè Florio
M
M
Greco
M
M
Longoni
M
M
Luppi
M
M
Magnani
M
M
Mazzone
M
M
Pastorello
M
M
Pazzaglia
M
M
Ravaglia
M
M
Zammataro
M
M
Zanna
M
M
Bressan
M A
MA
Saggese
M P
MP
Gentiloni Silveri
N
N
Scopetta
N
N
De Mitri
O
O
Fantin
O
O
Boscolo
P
P
Cancemi
P
P
De Angelis
P
P
Di Pietro
P
P
Mosca
P
P
Pacelli
P
P
Torboli
P
P
Copetti
R
R
Fazio
R
R
Losordo
R
R
Melandri
R
R
Papitto
R
R
Chiaravalle
S
S
Orlando
S
S
Sturlese
U
U
Di Grande
A
A
Narbone
G
G
Zimmermann
H
H
Martinelli
L
L
Clanchini
V
V
Paternosto
D
D
Fiorilli
M
M
Del Prato
C
C
Becheri
M
M
Lanigra
M
M
Guerra
G
G
Sinno
C
C
Soragna
A
A
Ferranio
M P
MP
Bua
V
V
Capra
R
R
Lualdi
E
E
D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards*; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D010343:Patient Admission / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D014218:Triage