Emergency medicine journal : EMJ
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Observational Study
ED healthcare professionals and their notions of productivity.
The combination of constrained resources, patient complexity and rapidly increasing demand has meant that healthcare productivity constitutes a significant problem for emergency medicine. However, healthcare productivity remains a contentious issue, with some criticising the level of professional engagement. This paper will propose that productivity improvements in healthcare could occur (and be sustained) if professionals' perceptions and views of productivity were better understood. ⋯ By exploring how these HCPs experienced and made sense of productivity improvement and productive healthcare, the data reveals how HCPs may reconcile a culture of caring with one of efficiency. Understanding healthcare productivity from this perspective has potential implications for service improvement design and performance measurement.
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Despite sustained high vaccination coverage and a national guideline by the Health Council (HC-guideline) on tetanus postexposure prophylaxis (T-PEP), tetanus sporadically occurs in the Netherlands. This study aims to assess the added value of a bedside test for tetanus immunity (Tetanos Quick Stick (TQS); Ingen BioSciences Group, France), in the context of routine T-PEP in two adult cohorts: those born before introduction of tetanus toxoid vaccination in the National Immunization Programme (NIP) in 1957 (pre-NIP-cohort; n=196) and those born after (NIP-cohort; n=405). ⋯ Use of the TQS would allow better targeting of T-PEP. Furthermore, stricter adherence to the HC-guideline can prevent overimmunisation and decrease the risk of tetanus.
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Policies addressing ED crowding have failed to incorporate the public's perspectives; engaging the public in such policies is needed. ⋯ These findings suggest that the general public may be open to flexible models of emergency care. The jury provided clear recommendations for direct public input to guide health policy to tackle ED crowding.