Reorganisation of emergency departments: From policy to practice

Background: In 2007, a national policy of emergency department reorganisation was announced in Denmark. To obtain the expected benefits policy, must be put into practice. The aim this study is to assess relation between and practice after announcement.
 Methods: designed as cross-sectional we conducted survey across all Danish departments (n=21), implementation from 2007-2017. questionnaire answered by executive staff at EDs (100% response rate). We applied multi-contingency theory an analytical framework classify recommendations (specialised equipment, centralisation, multidisciplinary teams, triage, flow coordinator, senior physician, qualification upgrade) according key organisational design dimensions (strategy, structure, coordination, staff, incentive structure) known affect patient outcome. further guides our analysis expectations process ED impact.
 
 Results: rate varied dimensions: Coordination (multidisciplinary coordinator) first implemented terminated highest rates 86-100%, whereas structure equipment centralisation) (senior physicians were more sluggish with implementations 10-76% 33-90%, respectively. did not adhere strategy identified missing policy.
 Conclusion: found hesitant heterogeneous translation practice, probably due cooperation recruitment challenges. According framework, these issues might caused lack linkage theory. However, most developed new coordination strategies resolve issues. Since suggest complete plan, it surprising, that have tried develop independent solutions. It also shows if only partial specified no time limits, may take different routes.