Notice bibliographique
Résumé
What Is the Issue? Emergency departments (EDs) across Canada are under strain and experiencing overcrowding, a situation that arises when the demand for health services in the ED exceeds the capacity of the health system — which includes the ED, hospital, and community — to provide quality care in a reasonable amount of time. ED overcrowding is contributing to a deteriorating standard of care as health care providers and staff become overworked and burned out, is putting health and lives at risk, and is placing additional strain on an already overwhelmed health care system. What Did We Do? The CADTH Health Technology Expert Review Panel (HTERP) convened to develop objective, impartial, trusted pan-Canadian guidance to inform decisions about which evidence-informed solutions should be considered to help alleviate ED overcrowding in Canada. What Is HTERP’s Position on ED Overcrowding? ED overcrowding is a complex health system issue. EDs operate within hospitals and broader health and social systems, which means that accountability for causes, impacts, and solutions do not lie solely within the ED and its operations. Output factors (e.g., misalignment between acute care bed capacity within the hospital and population needs) and input factors (e.g., misalignment between care available in the community and population needs, including care outside of regular business hours) respectively, are the main contributors to ED overcrowding in Canada. Health system capacity is not aligned with, nor has kept pace with, the growing and changing health care needs of the population, which results in overcrowded EDs. Health systems will observe better results by implementing strategies that improve patient flow and focus on output and input factors relative to throughput factors. What Is HTERP’s Guidance to Help Alleviate ED Overcrowding? Interventions to alleviate overcrowding need to align with the main contributing factors to ED overcrowding in the particular context in which they will be implemented. Understanding the context in which ED overcrowding is occurring, with attention to bottlenecks to patient flow, should be the first step to identify evidence-informed solutions. Transparency and accountability should be key principles in ED, hospital, and health system operations. HTERP recommends identifying and ensuring clear roles, responsibilities, and reporting relationships embedded within an accountability framework for ED overcrowding across health system partners, including a commitment to act on data. Each province and territory should mandate consistent and comprehensive reporting by all hospitals to the Canadian Institute of Health Information’s National Ambulatory Care Reporting System (NACRS) database. HTERP’s guidance includes an Evidence Navigation Guide to support identification of evidence-informed interventions to help alleviate ED overcrowding.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,012 | 0,039 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,004 | 0,011 |
| Études des sciences et des technologies | 0,005 | 0,002 |
| Communication savante | 0,005 | 0,002 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».