1. Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes
- Author
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Julie Considine, Sandy Middleton, Simeon Dale, Jeremy M. Grimshaw, Christopher Levi, Dominique A Cadilhac, Richard P. Gerraty, Catherine D'Este, N. Wah Cheung, Oyebola Fasugba, Elizabeth McInnes, Mark Fitzgerald, Verena Schadewaldt, and Benjamin McElduff
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cross-sectional study ,emergency care ,Organizational culture ,Context (language use) ,Audit ,research utilization ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Outcome Assessment, Health Care ,Health care ,medicine ,Humans ,030212 general & internal medicine ,Stroke ,General Nursing ,Aged ,Quality of Health Care ,Retrospective Studies ,030504 nursing ,business.industry ,Medical record ,Australia ,Retrospective cohort study ,Middle Aged ,knowledge transfer ,medicine.disease ,Organizational Culture ,guideline implementation ,organizational cont ,Cross-Sectional Studies ,Alberta Context Tool ,Family medicine ,Female ,Perception ,Emergency Service, Hospital ,0305 other medical science ,business - Abstract
Background Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. Purpose To identify how context affects the provision of stroke care in 26 Australian EDs. Method Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes. Findings Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context. Discussion Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.
- Published
- 2021
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