References of "Ghuysen, Alexandre"
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See detailBreaking Bad News: the TAKE five program.
GILLET, Aline ULg; VAN CAUWENBERGE, Isabelle ULg; TUBES, Rebecca ULg et al

Poster (2016, October)

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See detailProofing & Reduction Strategies Used by Emergency Residents to Manage Fatigue-related Risk
Berastegui, Pierre ULg; Ghuysen, Alexandre ULg; Nyssen, Anne-Sophie ULg

Poster (2016, July 29)

Fatigue and sleep loss are typically associated with psychomotor and cognitive impairment resulting in poorer task performance. Most of these studies are conducted in controlled settings and involve the ... [more ▼]

Fatigue and sleep loss are typically associated with psychomotor and cognitive impairment resulting in poorer task performance. Most of these studies are conducted in controlled settings and involve the completion of experimental tasks. Only a few field studies involving exhausted residents have been conducted over the past decade, and they yielded to contradictory results (Ellman et al., 2004). One of the key factors that could be involved in the non-linear relationship between fatigue and performance in specific work context reside in the mobilization of Fatigue Proofing Strategies. FPS are adaptive and protective risk-reduction behaviors that improve the resilience of a system of work (Dawson et al., 2012). In this study, we aimed to identify and classify proofing strategies mobilized by EMS residents using an inductive content analysis approach. EMS residents reported a range of strategies for reducing subjective level of sleepiness (reduction strategies, n=15) or managing its consequences (proofing strategies, n=17). Content analysis yielded to three sub-categories of proofing strategies: Behavioral Compensation (n=8), Error’s Opportunity Reduction (n=5) and Error’s Consequences Mitigation (n=4). Our results show that EMS residents use both types of strategies although none of the proofing strategies were part of their training program. Despite the current informal use, there is significant potential for implementation of more formal processes. [less ▲]

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See detailGestion des flux patients et surpopulation des urgences : Heurs et malheurs de la fonction de « Bed Manager ».
GILLET, Aline ULg; Minder, Anaïs ULg; Nyssen, Anne-Sophie ULg et al

Conference (2016, July 11)

For many years, emergency departments (ED) overcrowding has become a major issue in Public Health. Many studies have demonstrated the efficiency of flow management coordination on this recurrent problem ... [more ▼]

For many years, emergency departments (ED) overcrowding has become a major issue in Public Health. Many studies have demonstrated the efficiency of flow management coordination on this recurrent problem, by offering an interface between the ED, the hospital and out-of-hospital structures and by coordinating patients’ movements towards hospital care units. This was the basis for the implementation of "bed management" coordination program in the ED of the University Hospital of Liège in January 2014. The present study evaluates the adequacy of the Bed Manager (BM) activity with actual ED and hospital workload. Our results describe the rate of intra-hospital patients’ transfers according to the adequacy of the destination unit and time delays for these transfers. Head nurses from specific care units were interrogated about their perceptions of BM activity. We are now convinced by the importance of a participative approach in the development of ED bed management and working procedures, as well as the usefulness of further studies to explore this complex activity. [less ▲]

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See detailWhy is this urine turning blue? A uncommon alarm but a common disease.
LU, Marie Anh-Dao ULg; GENSBURGER, Mathieu ULg; TONGLET, Martin ULg et al

Poster (2016, January 30)

Turning purple-blue urine is an alarming phenomenon uncommonly seen in patients with chronic urinary catheterization. Such discoloration, often misdiagnosed as haematuria, frequently causes concerns for ... [more ▼]

Turning purple-blue urine is an alarming phenomenon uncommonly seen in patients with chronic urinary catheterization. Such discoloration, often misdiagnosed as haematuria, frequently causes concerns for the nurses, the doctor, the patient and his family. [less ▲]

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See detailEmergency department bed coordination: burden and pitfalls.
GILLET, Aline ULg; Minder, Anaïs ULg; Nyssen, Anne-Sophie ULg et al

Conference (2016, January 30)

Introduction Improving patient flow from emergency department (ED) to in-hospital bed admission has become an everyday challenge. Implementation of an ED bed manager (BM) who monitors hospital beds ... [more ▼]

Introduction Improving patient flow from emergency department (ED) to in-hospital bed admission has become an everyday challenge. Implementation of an ED bed manager (BM) who monitors hospital beds availability daily has been advocated to reduce boarding time for admitted patient. However, little is known on the actual burden and pitfalls of ED bed coordination. Indeed, overcrowded hospitals often lead to inappropriate transfer from ED to less adapted hospital unit or unit with lower level of care. We design the present study to evaluate the occurrence of such step-down units transfer. Methods This prospective study was conducted in a tertiary care academic hospital accounting for 622 licensed beds and an ED census of 45000/year. In 2014, a BM was implemented as a result of a quality improvement program. Focus was made solely on facilitating and improving patient movements form ED to the hospital wards. The investigators extracted data from a 20-days random observation period in February and March 2015, or a total of 231 patients administered by the BM. Results During this period, mean ED census was 131 (±12) patients /day, of which mean hospital admission rate was 20,6 %. BM administered 12 (±3) of these patients daily. Most of these patients were transferred to an appropriate unit (47.6 %) or a short stay unit (32.1%), while 17.7 % were referred to under adapted units and 2.6 % to step down units. Patients’ average length of stay (LOS) was 32 hours. LOS for patients immediately admitted in the ED short stay unit (n=74) was 26.5 (±22) hours, while it took 35.8 (±26) hours to reach an appropriate unit (n=110) and 35.6 (±27.4) to reach a less-appropriate unit (n=41). Interestingly, patients transferred to a non-appropriate unit (n=6) stayed 29.5 (±15.7) hours in the ED. Communications means used by the BM was face-to-face talk almost half of the cases (n=93) and phone calls for the other half (n=115). Discussion and conclusion These results emphasize the complexity of ED flow coordination. Whether or not such coordination is effective on ED overcrowding or patients’ LOS, this preliminary study identifies the frequent use of short stay and under-adapted units instead of optimal bed location. Besides, further research should clarify the impact of these hospitalisations’ pathways on the quality of care. Finally, these observations indicate the urgent need for early determination of patients who could actually be safely transferred to such units. [less ▲]

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See detailCognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?
Gillet, Aline ULg; GHUYSEN, Alexandre ULg; BONHOMME, Suzanne ULg et al

in European Journal of Emergency Medicine (2015), 22(3), 192-198

AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then ... [more ▼]

AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling. RESULTS: Our results showed that the patient's medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools. CONCLUSION: The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care. [less ▲]

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See detailThe Mediation Service, what interest for emergencies?
PIAZZA, Justine ULg; BRASSEUR, Edmond ULg; DOPPAGNE, Caroline ULg et al

Poster (2015, January 17)

Detailed reference viewed: 30 (4 ULg)