Stručni rad
THE IMPORTANCE OF MAPPING THE PROCESSES OF EMERGENCY MEDICAL SYSTEM – EXAMPLE OF CASE STUDY IN CROATIA
MAJA BANADINOVIĆ
orcid.org/0000-0002-5254-1971
; Sveučilište u Zagrebu, Medicinski fakultet, Škola narodnog zdravlja “Andrija Štampar“, Zagreb, Hrvatska
ALEKSANDAR DŽAKULA
orcid.org/0000-0002-0013-3108
; Sveučilište u Zagrebu, Medicinski fakultet, Škola narodnog zdravlja “Andrija Štampar“, Zagreb, Hrvatska
DORJA VOČANEC
orcid.org/0000-0001-7570-5863
; Sveučilište u Zagrebu, Medicinski fakultet, Škola narodnog zdravlja “Andrija Štampar“, Zagreb, Hrvatska
ADIS KERANOVIĆ
orcid.org/0000-0002-9506-6891
; Klinički bolnički centar Zagreb, Objedinjeni hitni bolnički prijam, Zagreb, Hrvatska
Sažetak
Aim: The general aim of this study was to point to the lack of procedures for evidence-based decision making in healthcare and to show the negative impact that media interpretations may have on decision-making. Methods: Review and analysis of media reports of the case was conducted with a qualitative method of narrative inquiry and a technique for analyzing newspaper articles. The subject of the research was public discourse on the organization of health care shown through the prism of emergency medical system, using the example of a specifi c case of death of the patient in one of the university hospital centers in Croatia. The analysis included media reports related to the mentioned case on the web portals of four major national media, i.e. Index.hr, Jutarnji list, Večernji list and Slobodna Dalmacija. The search was conducted using the keywords of the case on the web portals of the mentioned media. Results: Four daily national newspapers were searched using the content analysis methodology. The search included articles published between December 14, 2018 and December 19, 2019, in total 135 reviewed and analyzed newspaper articles. All included articles focused on the question of who was responsible or guilty and why the patient died. An analytical discourse was formed in the public and in the media about the organization of health care, primarily emergency medical services, which was initiated due to the death of the patient. Four groups of stakeholders who participated in the creation of the discourse were identifi ed using article analysis, i.e. people responsible for the organization and management of the health care system, healthcare professionals, citizens and journalists. The case was analyzed by looking at the perspective of all four stakeholders. Discussion: Data on the state of health related to the observed case showed that there were no deviations in the structural elements of the system and that they were consistent with the regulations that prescribe minimum conditions in terms of space, people and equipment. The results showed that there were signifi cant differences in the understanding of the situation or a problem in each of the fi ve categories defi ned according to Antonacci et al. Differences existed between the assumed organizational solutions in the system and the ways in which it was recognized and explained by citizens and healthcare professionals through appropriate ‘media analytical’ discourse. The results of the analysis indicated the lack of process approach to management. Mapping and evaluating processes as a method had not been conducted in the care of the patient. System components that include human and material resources, as well as the relationships and activities in the care process were not clearly identifi ed. Conclusion: The process mapping method helps identify system deviations by identifying, analyzing, evaluating and mapping processes. By reconstructing the case, we realized how indicators of work organizational structure and outcomes were not the only factors contributing to the quality of care. By mapping and evaluating the process, we could follow the patient’s ‘path’ and, at any time, analyze critical sites and conduct improvements in a timely manner.
Ključne riječi
healthcare; ‘media analytical’ discourse; Emergency Medical System; process mapping
Hrčak ID:
236584
URI
Datum izdavanja:
16.3.2020.
Posjeta: 1.819 *