Does 'one size fits all' apply to Emergency Department quality improvement? A proof of principle study

To describe patient (i.e. demographics, presenting complaint, urgency and disease severity, type of referral and arrival), ED (i.e. number of ED visits) and hospital (location, urban vs academic) characteristics, and relevant clinical outcomes among 6 EDs in the Netherlands. And to identify independent determinants of relevant clinical outcomes for the total cohort and for different ED's. This is done by using the information from the NEED (Netherlands Emergency department Evaluation Database, StichtingNEED.nl)

If there is a discrepancy between the independent determinants identified for relevant clinical outcomes in all ED patients included in the NEED and the independent determinants identified in individual EDs, this would argue against a “one size fits all” quality improvement policy as is currently advocated.

Every 6 months from now until 2023 a download with ED-visit information from the participating hospitals will be added to the NEED and used for statistic analysis, e.g. logisitic regression, for reporting in subsequent scientific papers.