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https://hdl.handle.net/2440/80203
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Type: | Journal article |
Title: | Barriers to the 4-h rule: what causes delays for gynaecology patients in the emergency department? |
Author: | Pakmehr, S. Petersen, R. Quinlivan, J. |
Citation: | Australian and New Zealand Journal of Obstetrics and Gynaecology, 2013; 53(1):46-50 |
Publisher: | Blackwell Publishing Asia |
Issue Date: | 2013 |
ISSN: | 0004-8666 1479-828X |
Statement of Responsibility: | Sahar Pakmehr, Rodney W. Petersen and Julie A. Quinlivan |
Abstract: | <h4>Objectives</h4>To explore factors that led to noncompliance with the 4-h rule for gynaecology patients in a general emergency department.<h4>Methods</h4>A cross-sectional cohort study was performed at a general emergency department. The files of all female patients aged from birth to 100 years presenting from 1 January 2009 to 31 December 2010 were screened. Those patient's files where a coded gynaecological diagnosis was made were reviewed. A time flow analysis was then undertaken of 580 consecutive files to evaluate barriers to admission or discharge of patients within the 4-h period. A further 300 files were audited to determine whether suboptimal management by emergency department staff contributed towards delays.<h4>Results</h4>There were 134 438 presentations to the emergency department, of which 2968 were gynaecology presentations (2.2%). The overall compliance with the 4-h rule was 66%. Patients with acute triage status, who were pregnant or who were eventually admitted, were more likely to be managed in compliance with the 4-h rule. The main barriers to compliance were incomplete examinations by emergency department staff; waiting for ultrasound examinations and blood test results; delays waiting for specialty review; and delays caused by initial review by surgical teams.<h4>Conclusion</h4>Specific barriers to compliance with the 4-h rule can be identified in gynaecology patients. Strategies specific to overcome these barriers can be developed to improve compliance. |
Keywords: | 4-h rule compliance delays for care emergency gynaecology |
Rights: | © 2012 The Authors |
DOI: | 10.1111/ajo.12025 |
Published version: | http://dx.doi.org/10.1111/ajo.12025 |
Appears in Collections: | Aurora harvest 4 Obstetrics and Gynaecology publications |
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