Background: The centers of disease control and prevention define
a non-urgent
Emergency Department (NU-ED) visit as a medical condition requiring treatment
within more than 24 hours. These visits constitute one of the main reasons for
emergency department (ED) overcrowding, which greatly affects healthcare
workers’ wellbeing, health costs, patients’ satisfaction and treatment
outcomes. Currently, there is no solid definition of non-urgent emergency
visits, which is the first step towards dealing and potentially solving this
issue. Having that, the aim of the current study is to define and validate the criteria for
NU-ED visits in Israel. Methods: This qualitative study included twelve senior physicians and nurses working
in Emergency Department and/or Health Maintenance
Organizations (HMOs) across Israel. The study was performed using in-depth, semi-structured, open-ended interviews. Qualitative data analysis was performed by conventional content
analysis. Results: The
urgency of medical visits was defined based on these two questions: 1) Does the medical condition require an immediate
treatment? 2) Is the emergency department the only place that can provide the
required treatment at a certain timepoint? We found that non-urgent visits
mostly occur during the nights and weekends, when medical treatments are not
available in the HMOs. Visitors for non-urgent cases mostly complained about minor injuries or chronic conditions, fever, abdominal or chest pain.
Most visits occurred based on referral from the family physician or the nurse
from the call center. Participants reported a lack of awareness and knowledge
about the roles of the EDs and the available options in the HMOs, which seem unable to
provide patients with appropriate treatments. The usage of triage scales seems
to ensure that patients are being treated based on the clinical urgency of
their condition. Medical cases that score above 3 can be defined as non-urgent visits. Therefore,
implementation of
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