@article{ad28cae451e040458be3cedd037c23b4,
title = "Organisation of internal medicine in acute care in the Netherlands: a detailed overview",
abstract = "Background: Organisation of the emergency department (ED) is gaining attention due to an increased demand on emergency services, leading to crowding and influencing the quality of care. It is known that the organisation of acute care influences the performance of the ED. In the Netherlands, the organisation of EDs differs between hospitals. However, detailed information about the various organisational structures is lacking. This study aims to determine the organisational structures and the different roles and responsibilities of internists and emergency physicians (EPs) in the EDs.Methods: We performed a nationwide observational study between January 2018 and February 2019. All hospitals with an ED in the Netherlands were identified, contacted, and surveyed. Requested information was retrieved from internists and complemented with local administrative hospital data.Results: 76 out of 89 EDs responded to the questionnaire (84%); 93% of EDs were operational 24/7. A registered acute internist was present at 47 locations (62%) and an EP at 60 EDs (79%). At 10 locations (13.2%), internists reported not being physically present at the ED. Supervision and working agreements between EPs and internists differed between the hospitals. Collaboration between EPs and internists was graded satisfactory (7.4/10).Conclusion: This is the first study providing a detailed overview of the ED organisation in the Netherlands regarding internal medicine patients. This organisation differs in terms of staffing, presence of EPs and internists, and working agreements. The influence of the various organisational structures of EDs on quality of acute care should be the subject of future research.",
keywords = "acute care, emergency department, healthcare organisation, internal medicine, performance, PERFORMANCE, Acute care",
author = "M.N.T. Kremers and J.J.H. Wachelder and P.W.B. Nanayakkara and H.R. Haak and {ORCA Acute Medicine Research Consortium}",
note = "Funding Information: Grant support This study was funded by the science fund of the Netherlands Association of Internal Medicine. The authors declare that they have no competing interests. We thank all the internists who took part in the study and special thanks to the members of the ORCA (Onderzoeks Consortium Acute Geneeskunde) Acute Medicine Research Consortium for their cooperation. Members of the ORCA consortium are: Nanayakkara PWB, Amsterdam University Medical Center, location Vu University Medical Center, the Netherlands; Haak HR, M?xima MC, the Netherlands; Alsma J, Erasmus University Medical Center, the Netherlands; Kremers MNT, Maastricht University and CAPHRI School for Public Health and Primary Care, Aging and Long Term care Maastricht, the Netherlands; Uffen JW, University Medical Center Utrecht, the Netherlands; Fogteloo AJ, Leiden University Medical Center, the Netherlands; Groeneveld GH, Leiden University Medical Center, the Netherlands; Bauer MP, Leiden University Medical Center, the Netherlands; Carels RA, Ikazia Hospital, the Netherlands; Dees A, Ikazia Hospital, the Netherlands; Schuit SCE, Erasmus University Medical Center, the Netherlands; Brouwer R, Medisch Spectrum Twente, the Netherlands; Brink H, Medisch Spectrum Twente, the Netherlands; Holleman F, Amsterdam University Medical Center, location AMC, the Netherlands; van Nieuwkoop C, Haga Teaching Hospital, the Netherlands; Hoogerwerf JJ, Radboud University Medical Center, the Netherlands; Kaasjager KHAH, University Medical Center Utrecht, the Netherlands; Vrijsen BEL, University Medical Center Utrecht, the Netherlands; Schouten WEM, OLVG location East, the Netherlands; Ter Maaten JC, University Medical Center Groningen, the Netherlands; Ligtenberg JJM, University Medical Center Groningen, the Netherlands; Stassen PM, Maastricht University Medical Center, the Netherlands; van Noord C, Maasstad Hospital, the Netherlands; van Leeuwen-Nguyen HTT, Maasstad Hospital, the Netherlands; Govers A, Sint Franciscus Gasthuis & Vlietland, the Netherlands; Bosch FH, Rijnstate Hospital, the Netherlands; Buunk G, Amphia Hospital, the Netherlands; van Herpt TTW, Amphia Hospital, the Netherlands; de Regt MJA, OLVG, the Netherlands. Funding Information: This study was funded by the science fund of the Netherlands Association of Internal Medicine. The authors declare that they have no competing interests. We thank all the internists who took part in the study and special thanks to the members of the ORCA (Onderzoeks Consortium Acute Geneeskunde) Acute Medicine Research Consortium for their cooperation. Members of the ORCA consortium are: Nanayakkara PWB, Amsterdam University Medical Center, location Vu University Medical Center, the Netherlands; Publisher Copyright: {\textcopyright} MacChain. All rights reserved.",
year = "2020",
month = sep,
day = "1",
language = "English",
volume = "78",
pages = "251--260",
journal = "Netherlands Journal of Medicine",
issn = "0300-2977",
publisher = "Van Zuiden Communications",
number = "5",
}