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Master Thesis

État des lieux du secteur orange du CHU de Caen et identification des consultations sans acte diagnostique, ni thérapeutique

Abstract : Introduction: Overcrowding is a common issue confronting EDs today. In 2015, a fast-track unit, the “Orange Area” opened in Caen University Hospital, in order to optimize the ED effectiveness and length of stay. In the response to the constant increase in patient numbers, and is now handling 40% of the total visits to the ED. The aim of our study is to make an assessment of the fast-track unit and, over the study period, to evaluate and identify the consultations without any diagnosis or treatment act (DOTA). Method: The data of patients received in the Orange unit of the emergency services in Caen-CHU, during working hours, between the 5th and 18th of March 2018 were retrospectively analyzed. The patient’s characteristics and their outcomes were gathered, as well as DOTA performed. The impact and the factors associated with a consultation without DOTA have been identified. Results: The consultations without DOTA represented 30% of the Orange Unit consultation during working hours. The main reasons for these consultations were rheumatological (16% vs 8.7% p = 0.016), dental stomatology (14% vs 6.3% p < 0.01), ENT (12% vs 2.1% p < 0.01). Time taken to process them were less than 3 hours (OR = 4.03; p < 0.01). A previous GP consultation is an independent predictive factor in not resulting in a consultation without DOTA (OR = 0.364; p < 0.01), in the same way as presenting for a traumatological reason (OR = 0.0801; p < 0.001). Conclusion: Almost a third of the Orange Unit consultations could have been dealt with in the practice of a GP in town. Information for patients about the healthcare circuit and the role of the GP in the care of many consultation reasons in the emergency services, is a key element in the improvement of the fast-track unit.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02469744
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Submitted on : Thursday, February 6, 2020 - 5:13:22 PM
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Oriane Chalumeau. État des lieux du secteur orange du CHU de Caen et identification des consultations sans acte diagnostique, ni thérapeutique. Médecine humaine et pathologie. 2019. ⟨dumas-02469744⟩

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