Articles: emergency-services.
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The authors describe a five-year continuous quality improvement program that monitors inpatient and outpatient satisfaction with emergency services offered by a multi-institutional health care system. The program provides managers with the information to develop detailed plans for service improvement and suggests ways to appraise performance and recognize personnel.
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The authors conducted a field experiment in which emergency-room patients of a metropolitan hospital were either given or not given an expected waiting time to see a physician. Patients were then surveyed through the mail on their satisfaction and perceptions of service quality. ⋯ In addition, satisfaction was independently influenced by whether patients' prior timeliness expectations were confirmed. The authors discuss the results in terms of the concept that the situational context of the service may influence the quality dimensions that most affect consumer satisfaction.
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To determine the distribution and scope of nurse practitioner schemes in accident and emergency departments in England and Wales; to describe the caseloads of doctors and nurse practitioners on two representative days; and to estimate the number of patients managed by nurse practitioners in the year to 31 March 1991. ⋯ Designated nurse practitioner schemes are rare. The volume and range of nurse practitioner work in major general accident and emergency departments is small compared with those in specialised and minor accident and emergency departments.
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The massification of pediatric hospital emergency departments (PED) is due to bad use of the same by a large number of users. The causes related with this inadequate use have not been properly evaluated. ⋯ Pediatric hospital emergency departments receive a high number of inadequate consultations at the second level of health care. The importance of the age of the patient, accessibility of pediatric hospital emergency departments and who takes the initiative to come must be emphasized as predictive variables of the bad use of these pediatric departments.