La tunisie Medicale - 2020 ; Vol 98 ( n°06 ) : 446-455
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Summary

Objective: to converge towards a general agreement on the organization and operation of an emergency department.
Methods: A participatory approach using the Delphi method was carried out with experts from emergency department staff and teaching hospital managers of Blida (Algeria).In the first round, experts were asked to express their degree of agreement on 30 items of the questionnaire on a seven point Likert scale, this to identify consensual items on the basis of an average rating of at least six. In the second round, the experts were asked to prioritize the consensual items. The experts participated anonymously in the study and any direct meetings between the experts were avoided.
Results: A total of 190 experts participated in the first round, representing an overall participation rate of 77.2%. The first round identified 12 consensual items. Consensus was predictable for some items, such as the important role of the nurse or doctor reception in a emergency department (m = 6.0±1.5), but the response to other items was unexpected. Thus, the proposal that a patient already hospitalized in a required specialty service should never return to the emergency department was not the subject of consensus (m = 5.2±2.2). Correlation of rankings of consensual items by experts was significant but weak (Kendall W = 0.164, p < 10-3).
Conclusion: This study highlights contradictions and inconsistencies resulting from the improvisation that accompanied the birth of the emergency department in the teaching hospital of Blida.Major information and pedagogical efforts are needed to organize a new emergency department.

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