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Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective
BACKGROUND: The Four-Hour Rule or National Emergency Access Target policy (4HR/NEAT) was implemented by Australian State and Federal Governments between 2009 and 2014 to address increased demand, overcrowding and access block (boarding) in Emergency Departments (EDs). This qualitative study aimed to...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354365/ https://www.ncbi.nlm.nih.gov/pubmed/30700302 http://dx.doi.org/10.1186/s12913-019-3877-8 |
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author | Forero, Roberto Nahidi, Shizar de Costa, Josephine Fatovich, Daniel FitzGerald, Gerry Toloo, Sam McCarthy, Sally Mountain, David Gibson, Nick Mohsin, Mohammed Man, Wing Nicola |
author_facet | Forero, Roberto Nahidi, Shizar de Costa, Josephine Fatovich, Daniel FitzGerald, Gerry Toloo, Sam McCarthy, Sally Mountain, David Gibson, Nick Mohsin, Mohammed Man, Wing Nicola |
author_sort | Forero, Roberto |
collection | PubMed |
description | BACKGROUND: The Four-Hour Rule or National Emergency Access Target policy (4HR/NEAT) was implemented by Australian State and Federal Governments between 2009 and 2014 to address increased demand, overcrowding and access block (boarding) in Emergency Departments (EDs). This qualitative study aimed to assess the impact of 4HR/NEAT on ED staff attitudes and perceptions. This article is part of a series of manuscripts reporting the results of this project. METHODS: The methodology has been published in this journal. As discussed in the methods paper, we interviewed 119 participants from 16 EDs across New South Wales (NSW), Queensland (QLD), Western Australia (WA) and the Australian Capital Territory (ACT), in 2015–2016. Interviews were recorded, transcribed, imported to NVivo 11 and analysed using content and thematic analysis. RESULTS: Three key themes emerged: Stress and morale, Intergroup dynamics, and Interaction with patients. These provided insight into the psycho-social dimensions and organisational structure of EDs at the individual, peer-to-peer, inter-departmental, and staff-patient levels. CONCLUSION: Findings provide information on the social interactions associated with the introduction of the 4HR/NEAT policy and the intended and unintended consequences of its implementation across Australia. These themes allowed us to develop several hypotheses about the driving forces behind the social impact of this policy on ED staff and will allow for development of interventions that are rooted in the rich context of the staff’s experiences. |
format | Online Article Text |
id | pubmed-6354365 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63543652019-02-06 Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective Forero, Roberto Nahidi, Shizar de Costa, Josephine Fatovich, Daniel FitzGerald, Gerry Toloo, Sam McCarthy, Sally Mountain, David Gibson, Nick Mohsin, Mohammed Man, Wing Nicola BMC Health Serv Res Research Article BACKGROUND: The Four-Hour Rule or National Emergency Access Target policy (4HR/NEAT) was implemented by Australian State and Federal Governments between 2009 and 2014 to address increased demand, overcrowding and access block (boarding) in Emergency Departments (EDs). This qualitative study aimed to assess the impact of 4HR/NEAT on ED staff attitudes and perceptions. This article is part of a series of manuscripts reporting the results of this project. METHODS: The methodology has been published in this journal. As discussed in the methods paper, we interviewed 119 participants from 16 EDs across New South Wales (NSW), Queensland (QLD), Western Australia (WA) and the Australian Capital Territory (ACT), in 2015–2016. Interviews were recorded, transcribed, imported to NVivo 11 and analysed using content and thematic analysis. RESULTS: Three key themes emerged: Stress and morale, Intergroup dynamics, and Interaction with patients. These provided insight into the psycho-social dimensions and organisational structure of EDs at the individual, peer-to-peer, inter-departmental, and staff-patient levels. CONCLUSION: Findings provide information on the social interactions associated with the introduction of the 4HR/NEAT policy and the intended and unintended consequences of its implementation across Australia. These themes allowed us to develop several hypotheses about the driving forces behind the social impact of this policy on ED staff and will allow for development of interventions that are rooted in the rich context of the staff’s experiences. BioMed Central 2019-01-30 /pmc/articles/PMC6354365/ /pubmed/30700302 http://dx.doi.org/10.1186/s12913-019-3877-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Forero, Roberto Nahidi, Shizar de Costa, Josephine Fatovich, Daniel FitzGerald, Gerry Toloo, Sam McCarthy, Sally Mountain, David Gibson, Nick Mohsin, Mohammed Man, Wing Nicola Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective |
title | Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective |
title_full | Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective |
title_fullStr | Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective |
title_full_unstemmed | Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective |
title_short | Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective |
title_sort | perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in australia: a qualitative social dynamic perspective |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354365/ https://www.ncbi.nlm.nih.gov/pubmed/30700302 http://dx.doi.org/10.1186/s12913-019-3877-8 |
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