Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation

Abstract Background Inadequate assessment of the severity and urgency of health problems is one of the factors contributing to unnecessary emergency department visits. A software-based instrument for standardized initial assessment (SmED) aims to support healthcare professionals and steer patients t...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Amanda Breckner, Catharina Roth, Joachim Szecsenyi, Michel Wensing
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Emergency medical services Outpatient emergency care service Software Point-of-care systems Germany Computer applications to medicine. Medical informatics R858-859.7
Acceso en línea:	https://doaj.org/article/3a3edffeaf1447799d03b262900f5e87
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3a3edffeaf1447799d03b262900f5e87
record_format	dspace
spelling	oai:doaj.org-article:3a3edffeaf1447799d03b262900f5e872021-11-21T12:28:59ZEnhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation10.1186/s12911-021-01685-61472-6947https://doaj.org/article/3a3edffeaf1447799d03b262900f5e872021-11-01T00:00:00Zhttps://doi.org/10.1186/s12911-021-01685-6https://doaj.org/toc/1472-6947Abstract Background Inadequate assessment of the severity and urgency of health problems is one of the factors contributing to unnecessary emergency department visits. A software-based instrument for standardized initial assessment (SmED) aims to support healthcare professionals and steer patients to the appropriate source of care. The aim of this study was to evaluate the implementation process of SmED based on the point of view of users in order to facilitate sustainable implementation. Methods A quantitative process evaluation on the basis of a paper-based questionnaire was carried out alongside the implementation of SmED in 26 outpatient emergency care services within 11 federal states in Germany. Healthcare professionals who worked with SmED either at the joint contact points of the outpatient emergency care service and the emergency departments of hospitals ("Joint Counter", German “Gemeinsamer Tresen”) or at the initial telephone contact points of the outpatient emergency care service (116117) were invited to participate in the survey. Results 200 users of SmED completed the questionnaire comprising the five scales: Intervention effectiveness/efficacy, Interprofessional context/occupational Interest, Individual Context, Organisational Framework Conditions, and Medical Context. Several individual characteristics were related to the implementation process of SmED. Female and younger healthcare professionals and participants with less than five years of professional experience tended to evaluate the implementation process as more positive. Factors related to the Individual Context and to the Medical Context were associated with the reported use of SmED (p = 0.004 and 0.041, respectively). Conclusion The involvement of healthcare professionals, particularly more experienced professionals, in the implementation of SmED may help to facilitate sustainable implementation. In addition, training of potential user prior and during the implementation process and the adaption of Organisational Context factors are crucial. Trial registration The study was registered at the German Clinical Trials Register prior to the start of the study (DRKS00017014).Amanda BrecknerCatharina RothJoachim SzecsenyiMichel WensingBMCarticleEmergency medical servicesOutpatient emergency care serviceSoftwarePoint-of-care systemsGermanyComputer applications to medicine. Medical informaticsR858-859.7ENBMC Medical Informatics and Decision Making, Vol 21, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Emergency medical services Outpatient emergency care service Software Point-of-care systems Germany Computer applications to medicine. Medical informatics R858-859.7
spellingShingle	Emergency medical services Outpatient emergency care service Software Point-of-care systems Germany Computer applications to medicine. Medical informatics R858-859.7 Amanda Breckner Catharina Roth Joachim Szecsenyi Michel Wensing Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation
description	Abstract Background Inadequate assessment of the severity and urgency of health problems is one of the factors contributing to unnecessary emergency department visits. A software-based instrument for standardized initial assessment (SmED) aims to support healthcare professionals and steer patients to the appropriate source of care. The aim of this study was to evaluate the implementation process of SmED based on the point of view of users in order to facilitate sustainable implementation. Methods A quantitative process evaluation on the basis of a paper-based questionnaire was carried out alongside the implementation of SmED in 26 outpatient emergency care services within 11 federal states in Germany. Healthcare professionals who worked with SmED either at the joint contact points of the outpatient emergency care service and the emergency departments of hospitals ("Joint Counter", German “Gemeinsamer Tresen”) or at the initial telephone contact points of the outpatient emergency care service (116117) were invited to participate in the survey. Results 200 users of SmED completed the questionnaire comprising the five scales: Intervention effectiveness/efficacy, Interprofessional context/occupational Interest, Individual Context, Organisational Framework Conditions, and Medical Context. Several individual characteristics were related to the implementation process of SmED. Female and younger healthcare professionals and participants with less than five years of professional experience tended to evaluate the implementation process as more positive. Factors related to the Individual Context and to the Medical Context were associated with the reported use of SmED (p = 0.004 and 0.041, respectively). Conclusion The involvement of healthcare professionals, particularly more experienced professionals, in the implementation of SmED may help to facilitate sustainable implementation. In addition, training of potential user prior and during the implementation process and the adaption of Organisational Context factors are crucial. Trial registration The study was registered at the German Clinical Trials Register prior to the start of the study (DRKS00017014).
format	article
author	Amanda Breckner Catharina Roth Joachim Szecsenyi Michel Wensing
author_facet	Amanda Breckner Catharina Roth Joachim Szecsenyi Michel Wensing
author_sort	Amanda Breckner
title	Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation
title_short	Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation
title_full	Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation
title_fullStr	Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation
title_full_unstemmed	Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation
title_sort	enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in germany: a quantitative process evaluation
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3a3edffeaf1447799d03b262900f5e87
work_keys_str_mv	AT amandabreckner enhancingimplementationofastandardizedinitialassessmentfordemandmanagementinoutpatientemergencycareingermanyaquantitativeprocessevaluation AT catharinaroth enhancingimplementationofastandardizedinitialassessmentfordemandmanagementinoutpatientemergencycareingermanyaquantitativeprocessevaluation AT joachimszecsenyi enhancingimplementationofastandardizedinitialassessmentfordemandmanagementinoutpatientemergencycareingermanyaquantitativeprocessevaluation AT michelwensing enhancingimplementationofastandardizedinitialassessmentfordemandmanagementinoutpatientemergencycareingermanyaquantitativeprocessevaluation
_version_	1718418999522361344

Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation

Ejemplares similares