References of "Ghuysen, Alexandre"
     in
Bookmark and Share    
Peer Reviewed
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 ▲]

Detailed reference viewed: 12 (0 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 38 (13 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 98 (31 ULg)
Full Text
Peer Reviewed
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: 20 (3 ULg)
Full Text
Peer Reviewed
See detailAir versus ground transport of patients with acute myocardial infarction: Experience in a rural-based helicopter medical service
MOENS, Didier ULg; Stipulante, Samuel ULg; Donneau, Anne-Françoise ULg et al

in European Journal of Emergency Medicine (2015)

Aims Primary pre-hospital Helicopter Emergency Medical Service (HEMS) interventions may play a role in timely reperfusion therapy for patients with ST-segment elevation myocardial infarction (STEMI). We ... [more ▼]

Aims Primary pre-hospital Helicopter Emergency Medical Service (HEMS) interventions may play a role in timely reperfusion therapy for patients with ST-segment elevation myocardial infarction (STEMI). We designed a prospective study involving patients with acute myocardial infarction aimed at the evaluation of the potential benefit of such primary HEMS interventions as compared with classical EMS ground transport. Methods & results This prospective study was conducted from July 1, 2007 to June 15, 2012. Successive patients with ST-segment elevation myocardial infarction (STEMI) eligible for percutaneous coronary intervention (PCI) were included. Simulated ground-based access times were computed using a digital cartographic program, allowing the estimation of healthcare system delay from call to admission to the catheterisation laboratory. During the study period, 4485 patients benefited from HEMS activations. Of these patients, 342 (8%) suffering from STEMI were transferred for primary PCI. Median primary response time time was 11 min (IQR: 8 - 14 min) using the helicopter and 32 min (25 – 44 min) using road transport. Median transport time using HEMS was 12 min (9 – 15 min) and 50 min (36 – 56 min) by road. The median system delay using HEMS was 52 min (45 – 60 min), while this time was 110 min (95 – 126 min) by road. Finally, the system delay median gain was 60 min (47 – 72 min). Conclusions Using HEMS in a rural region allows STEMI patients to benefit from appropriate rescue care with similar delays as those seen in urban patients. [less ▲]

Detailed reference viewed: 113 (12 ULg)
Full Text
Peer Reviewed
See detailLa régulation médicale et la chaîne de secours: La problèmatique des transferts primo-secondaires le modèle Belge en général et son application en province de Liège en particulier
BRASSEUR, Edmond ULg; GHUYSEN, Alexandre ULg; D'Orio, Vincenzo ULg

in Revue Médicale de Liège (2014), 68(10), 536-540

Medical regulation represents an essential tool for emergency medical assistance. Even if it is essentially based on a 1964 law, our medical regulation is constantly evolving to meet the present needs and ... [more ▼]

Medical regulation represents an essential tool for emergency medical assistance. Even if it is essentially based on a 1964 law, our medical regulation is constantly evolving to meet the present needs and to follow the medical and technological advances. In this article, we shall outline its major components and evoke some long-awaited developments in the field of public health. [less ▲]

Detailed reference viewed: 43 (9 ULg)
Full Text
Peer Reviewed
See detailSomething in the air
TAMBWE RAMAZANI, Willy ULg; BRASSEUR, Edmond ULg; JOHNSON, S et al

in Acta Clinica Belgica (2014), 69(S1), 28

Detailed reference viewed: 15 (2 ULg)
Full Text
Peer Reviewed
See detailAn unusual cervicalgy.
PIAZZA, Justine ULg; BRASSEUR, Edmond ULg; GHUYSEN, Alexandre ULg et al

in Acta Clinica Belgica (2014), 69(S1), 23

Detailed reference viewed: 22 (1 ULg)