Internal Medicine wards overcrowding and clinical risk management: Structural or systemic interventions needed?;Sovraffollamento nei reparti di degenza e clinical risk management in Medicina Interna: Soluzioni solamente strutturali o interventi sistemici sui Processi assistenziali?

Italian Journal of Medicine

Volumn 3, Issue 1, 2009, Pages 3-8

  Nardi, Roberto ^a,c   Gardellini, Aldina ^a   Iori, Ido ^b  

^a Azienda USL di Bologna   (Italy)

^b Dipartimento di Medicina Interna   (Italy)

^c MAGGIORE HOSPITAL   (Italy)

Author keywords

[No Author keywords available]

Indexed keywords

CROWDING; EDITORIAL; HOSPITAL BED; INTERNAL MEDICINE; MEDICAL DECISION MAKING; MEDICAL INFORMATION; OCCUPATION; ORGANIZATION; RISK MANAGEMENT; ROOT CAUSE ANALYSIS; WARD;

EID: 63449107259     PISSN: 18779344     EISSN: None     Source Type: Journal    
DOI: 10.4081/itjm.2009.3     Document Type: Editorial

References (36)

1. Nardi R, Scanelli G, Borloni D, et al. The assessment of complexity in internal medicine patients. The FADOI Medicomplex Study. Eur J Intern Med 2007;18(4):283-7.
2. Nardi R, Scanelli G, Tragnone A, et al. Difficult hospital discharges in internal medicine wards. Intern Emerg Med 2007;2(2);95-9.
3. Arienti V, Pretolani S, Luppi C, Pescerelli M, Botta C. II ricovero nei reparti di medicina interna: eccesso di domanda come causa di inappropriatezza. Intern Emerg Med 2008;3:S206-12.
4. Ministero della Salute. Stato di salute e prestazioni sanitarie nella popolazione anziana. 2000. http://www.ministerosalute. it/pubblicazioni/ ppRisultato.jsp?id=379
5. George G, Jell C, Todd BS. Effect of population ageing on emergency department speed and efficiency: a historical perspective from a district general hospital in the UK. Emerg Med J 2006;23(5):379-83.
6. Edwards N, Harrison A. Planning hospitals with limited evidence: a research and policy problem. BMJ 1999;319 (7221):1361-3.
7. Andrulis DP, Kellermann A, Hintz EA, Hackman BB, Weslowski VB. Emergency departments and crowding in United States teaching hospitals. Ann Emerg Med 1991;20(9):980-6.
8. Bagust A, Place M, Posnett JW. Dynamics of bed use in accommodating emergency admissions: stochastic simulation model. BMJ 1999;319(7203):155-8.
9. Green LV. How many hospital beds? Inquiry 2002-2003;39 (4):400-12.
10. Sprivulis PC, Da Silva J-A, Jacobs IG, et al. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med J Aust 2006;184(5):208-12.
11. Richardson DB. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J Aust 2006;184(5):213-6.
12. Tarnow-Mordi WO, Hau C, Warden A, Shearer AJ. Hospital mortality in relation to staff workload: a 4-year study in an adult intensive-care unit. Lancet 2000;356(9225):185-9.
13. Cameron PA. Hospital overcrowding: a threat to patient safety? Med J Aust 2006;184(5):203-4.
14. Borg MA. Bed occupancy and overcrowding as determinant factors in the incidence of MRSA infections within general ward settings. J Hosp Infect 2003;54(4):316-8.
15. Hugonnet S, Harbarth S, Sax H, Duncan RA, Pittet D. Nursing resources: a major determinant of nosocomial infection? Curr Opin Infect Dis 2004;17(4):329-33.
16. Cunningham JB, Kernohan WG, Rush T. Bed occupancy, turnover intervals and MRSA rates in English hospitals. Br J Nurs 2006;15(12):656-60.
17. Kibbler CC, Quick A, O'Neill AM. The effect of increased bed numbers on MRSA transmission in acute medical wards. J Hosp Infect 1998;39(3):213-9.
18. Borg MA, Suda D, Scicluna E. Time-series analysis of the impact of bed occupancy rates on the incidence of methicillinresistant Staphylococcus aureus infection in overcrowded general wards. Infect Control Hosp Epidemiol 2008;29(6):496-502.
19. Pittet D, Mourouga P, Perneger TV. Compliance with hand-washing in a teaching hospital. Infection Control Program. Ann Intern Med 1999;130(2):126-30.
20. Clements A, Halton K, Graves N, et al. Overcrowding and understaffing in modern health-care systems: key determinants in meticillin-resistant Staphylococcus aureus transmission. Lancet Infect Dis 2008;8(7):427-34.
21. Mishra RK. Hospital overcrowding. West J Med 2001;174 (3):170.
22. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA 2002;288(16):1987-93.
23. Virtanen M, Pentti J, Vahtera J, et al. Overcrowding in hospital wards as a predictor of antidepressant treatment among hospital staff. Am J Psychiatry 2008;165(11):1482-6.
24. Veronesi I, Nardi R. In: Nardi R, Lince M (eds). Risk management infermieristico in medicina interna. Torino: Centro Scientifico Editore, 2004:123-46.
25. Luppi C. Indagine sulla motivazione degli infermieri alla permanenza in area medico-geriatrica. Tesi di Laurea in Scienze Infermieristiche e Ostetriche. Università degli Studi di Roma Tor Vergata, 2006.
26. Fahrenkopf AM, Sectish TC, Barger LK, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ 2008;336(7642):488-91.
27. Buesching DP, Jablonowski A, Vesta E, et al. Inappropriate emergency department visits. Ann Emerg Med 1985;14(7):672-6.
28. RGPs of Ontario. Geriatric Emergency Management. Provincial Interim Report 2005-2006. Submitted to the Ministry of Health & Long-Term Care November 15, 2006, http://rgp.toronto.on.ca/PDFfiles/gem2005- 06yearendreportabridged.pdf
29. Moons P, De Ridder K, Geyskens K, et al. Screening for risk of readmission of patients aged 65 years and above after discharge from the emergency department: predictive value of four instruments. Eur J Emerg Med 2007;14(6):315-23.
30. Harari D, Martin FC, Buttery A, O'Neill S, Hopper A. The older persons' assessment and liaison team 'OPAL': evaluation of comprehensive geriatric assessment in acute medical inpatients. Age Ageing 2007;36(6):670-5.
31. British Geriatrics Society. The older person in the Accident & Emergency Department. BGS Compendium document 3.2 (revised March 2008). http://www.bgs.org.uk/Publications/ Compendium/compend-3-2.htm
32. Complexity and risk map. OntoSpace™. Comp: Ontonix, 2008.
33. Howell E, Bessman E, Kravet S, Kolodner K, Marshall R, Wright S. Active bed management by hospitalists and emergency department throughput. Ann Intern Med 2008;149 (11):804-11.
34. Nardi R. Progetto OSCAR. Ottimizzazione della terapia e della gestione dello scompenso cardiaco nell'anziano con ricoveri ripetuti. Progetto aziendale i nterd i parti menta le di ricerca-sperimentazione-azione sullo scompenso cardiaco nell'anziano. Bologna, 5 giugno 1999.
35. Fini M. (coord). Progetto Codice Argento. Modelli innovativi per la presa in carico del paziente anziano fragile nella transizione dall'ospedale al territorio e dal territorio all'ospedale. http://www.ministerosalute.it/imgs/C- 17-primopianoNuovo-210-documenti-itemDocumenti-0-fileDocumento.pdf
36. th International Symposium on "Multiple Risk Factors in CVD - Prevention and Intervention - Health Policy". Venice, Italy, October 22-25, 2008.