Inside triage: the social organization of emergency nursing work
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AbstractEmergency care in large urban hospitals across the country is in the midst of major redesign intended to improve access, decrease wait times and maximize efficiency. Using Institutional Ethnography, I was able to document critical, empiric evidence that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. The Canadian Triage and Acuity Scale figures prominently in the analysis as a high level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. The core argument throughout is that industrial production line values and principles that have infiltrated health care management and reframe patient care, are having serious consequences. This critical analysis uncovers a number of deleterious effects as rapid patient processing disrupts expert nursing work, and will contribute to a broader understanding of health system quality.
Bibliography: p. 209-228