Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Sep 2001
Review[Elective surgery--cancellations, ring fencing and efficiency].
We set out to study to what extent emergency admissions disturb elective surgical activities, resulting in decreasing efficiency and fewer elective procedures. We looked at the evidence of whether ring fencing elective surgery is an effective strategy to reduce disturbance from emergency activities, and improve the overall efficiency in hospitals with emergency as well as elective activities. ⋯ The belief that ring fencing is an effective strategy to decrease cancellations and increase hospital efficiency seems to be anchored in a priori reasoning rather than in published evidence.
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Treatment of major trauma is a demanding challenge for most hospitals. The potential benefits of improvement are substantial: it has been calculated that approx. 6,000 person-years are lost each year because of suboptimal treatment of trauma in Norway. Trauma teams, paging criteria, and manuals for appropriate resuscitative and diagnostic interventions are needed for improving the structure and quality of this service. ⋯ The results show that structural issues in relation to optimal trauma treatment still need more attention in Norwegian hospitals. Collaborative programmes for training and exchange of experience and procedures seem to be one way to go.