Health care providers' perception of the frequent emergency department user issue and of targeted case management interventions: a cross-sectional national survey in Switzerland.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_600FA67C7B82
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Health care providers' perception of the frequent emergency department user issue and of targeted case management interventions: a cross-sectional national survey in Switzerland.
Journal
BMC emergency medicine
Author(s)
Chastonay O.J., Lemoine M., Grazioli V.S., Canepa Allen M., Kasztura M., Moullin J.C., Daeppen J.B., Hugli O., Bodenmann P.
ISSN
1471-227X (Electronic)
ISSN-L
1471-227X
Publication state
Published
Issued date
07/01/2021
Peer-reviewed
Oui
Volume
21
Number
1
Pages
4
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Frequent users of emergency departments (FUEDs) (≥5 ED visits/year) represent a vulnerable population with complex needs accounting for a significant number of emergency department (ED) consultations, thus contributing to EDs overcrowding. Research exploring ED staff perceptions of FUEDs is scarce.
The current study aimed to evaluate in ED staff a) the extent to which FUEDs are perceived as an issue; b) their perceived levels of knowledge and understanding of FUEDs; c) levels of perceived usefulness of case management (CM) and interest in implementing this intervention in their ED service.
Head physicians of the EDs at all public hospitals in Switzerland (of various level of specialization) were sent a 19-item web-based survey, pilot tested prior to its dissemination. The head physicians were asked to forward the survey to ED staff members from different health professional backgrounds.
The hospital response rate was 81% (85/106). The exploitable hospital response rate was 71% (75/106 hospitals) including 208 responding health professionals. Issues and difficulties around FUEDs were perceived as important by 64% of respondents. The perceived frequency of being confronted with FUEDs was higher among nurses in more specialized EDs. In total, 64% of respondents felt poorly informed about FUEDs, nurses feeling less informed than physicians. The understanding of FUEDs was lower in the French-Italian-speaking parts (FISP) of Switzerland than in the German-speaking part. Eighty-one percent of respondents had no precise knowledge of FUED-related interventions. The perceived usefulness of CM interventions after receiving explanations about it was high (92%). However, the overall level of interest for CM implementation was 59%. The interest in CM by physicians was low across all regions and ED categories. Nurses, on the other hand, showed more interest, especially those in EDs of high specialization.
The majority of ED staff reported being confronted with FUEDs on a regular basis. Staff perceived FUEDs as a vulnerable population, yet, they felt poorly informed about how to manage the issue. The majority of ED staff thought a CM intervention would be useful for FUEDs, however there appears to be a gap in their desire or willingness to implement such interventions.
Keywords
Acceptability, Case management, Emergency department, Equity, Evidence-based practice, Frequent user, Health professionals’ perception, Implementation
Pubmed
Web of science
Open Access
Yes
Create date
20/01/2021 15:26
Last modification date
30/04/2021 7:11
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