A Realist Case Study of a Regional Hospital’s Response to Improve Emergency Department Access in the Context of Australian Health Care Reforms:

Health Services Research & Managerial Epidemiology

SandeepReddy¹ 

关键词: national health-care reforms;    emergency department access;    realist evaluation;    case study;    regional hospital;   

DOI  :  10.1177/2333392816631101

学科分类：医学（综合）

来源: Sage Journals

【 摘 要 】

Introduction:Major health-care reforms have extended across all Australian public hospitals in recent years. Improving emergency department (ED) access has been a focus of these reforms.Objective:This study evaluates how the national reforms have led to improvement in ED access in a regional hospital in remote Australia.Methods:Assessing a complex scenario such as national reforms and the challenges faced by the regional hospital to implement these reforms requires in-depth analysis. A realist evaluation theory-based approach was employed, allowing investigation of what, how, why, and for whom change occurred. A case study mixed methods design was adopted within the realist framework to answer these questions about change.Results and Conclusion:The study identified moderate improvement in ED access as a result of the reforms (investment in infrastructure and workforce and the introduction of ED targets). Clinical leadership and support from management were essential for the improvement. Without ongoing in...

【 授权许可】

CC BY