Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2019
Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand.
The present study explores factors related to length of stay (LOS) in a rural public hospital in Thailand and assesses the feasibility of using LOS as an ED key performance indicator. ⋯ Factors related to LOS in a rural hospital in Thailand are similar and in contrast to those of a previous study in a medical school setting. Reasons for the discrepancy of findings and implications for improving ED services were discussed. Our data support the notion of controversy in using LOS as a key indicator of ED performance in this rural hospital setting. Thus, it is imperative to not rely on any single throughput or process indicators to monitor ED performance, but to take into account a set of indicators including patient outcomes.
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Emerg Med Australas · Aug 2019
Patient-centred care through a broader lens: Supporting patient autonomy alongside moral deliberation.
Patient-centred care (PCC) is an essential component of high-quality healthcare and shared decision-making is its cornerstone. Yet, integrating the principles of PCC into healthcare practice is not always straightforward and shared decision-making can be complicated and ethically demanding. ⋯ The model encourages us to appreciate PCC through a broader lens and consider patient autonomy alongside other moral obligations such as justice and the equitable distribution of finite resources. The model can be used by healthcare providers, patients and caregivers to facilitate dialogue and moral deliberation regarding the merit of their preferences and values; in this way, individualised care can be delivered without compromising other important ethical obligations.