International perspectives on emergency care

Abualenain, Jameel; Mountain, David; Vaillancourt, Samuel; Schull, Michael J.; Anderson, Phillip D.; Revue, Eric; Patel, Brijal; Pourmand, Ali; Shokoohi, Hamid; Hori, Shingo; Quek, Lit Sin; Mason, Suzanne

doi:10.1002/9781118779750.ch3

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…As the Singaporean population grows (variable 32) and ages (variable 31) rapidly, patients with chronic medical conditions are expected to make up an increasing proportion of the ED workload in the future. 25 – 27 …”

Section: Methodsmentioning

confidence: 99%

Emergency department crowding in Singapore: Insights from a systems thinking approach

et al. 2016

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Objectives:Emergency Department crowding is a serious and international health care problem that seems to be resistant to most well intended but often reductionist policy approaches. In this study, we examine Emergency Department crowding in Singapore from a systems thinking perspective using causal loop diagramming to visualize the systemic structure underlying this complex phenomenon. Furthermore, we evaluate the relative impact of three different policies in reducing Emergency Department crowding in Singapore: introduction of geriatric emergency medicine, expansion of emergency medicine training, and implementation of enhanced primary care.Methods:The construction of the qualitative causal loop diagram is based on consultations with Emergency Department experts, direct observation, and a thorough literature review. For the purpose of policy analysis, a novel approach, the path analysis, is applied.Results:The path analysis revealed that both the introduction of geriatric emergency medicine and the expansion of emergency medicine training may be associated with undesirable consequences contributing to Emergency Department crowding. In contrast, enhancing primary care was found to be germane in reducing Emergency Department crowding; in addition, it has apparently no negative side effects, considering the boundary of the model created.Conclusion:Causal loop diagramming was a powerful tool for eliciting the systemic structure of Emergency Department crowding in Singapore. Additionally, the developed model was valuable in testing different policy options.

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Section: Methodsmentioning

confidence: 99%