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Hence, we have information for each hospital in the Yvelines on its type, activity, organization, and medical staff configuration.
Optimization is performed to find the optimal ED staff configuration, which consists of doctors, triage nurses, and admission personnel, i.e. a multidimensional problem.
The availability of intensive care, workload, staff configuration and the degree of urgency of the CS also need to be taken into account when analysing and comparing CS rates in this context.
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This has follow-on effects in multiple directions, including but not limited to staff configurations (teams vs. individuals) and the layout of the physical facility.
Our results also suggest that CS rates should be analysed according to available resources, workload and staff configurations.
To determine the effect of medical-staff configuration, we calculated the variation of elective CS rates between hospitals in women with either a low risk for CS (primiparous, <35 years old, with singleton pregnancy and no hypertensive disorders) or a high risk for CS (multiparous, >35 years old, with previous caesarean section and hypertensive disorders) in level I and IV hospitals [ 22].
This results in a staffing configuration quite different from clinical practice but logically consistent – PTs have higher direct patient contact than OTs and SALTs.
However, debate still exists regarding the optimal staffing configuration of air medical teams, and existing air medical services provide varying combinations of nurses, paramedics, and physicians.
Since GPs (Campbell et al, 2003) and patients expressed no clear preference for any specific service location or staffing configuration, cost is likely to be a major determinant of the nature of these services in the near future.
The increased movement of nurses into Australian general practice follows similar moves in the United Kingdom and New Zealand [ 3, 4] where the benefits of adding nurses to the staffing configuration, ranging from improved patient satisfaction to potential cost savings, have been well described [ 5].
As all of the HEMS responses are staffed exclusively with physicians, the results may not be generalizable to EMS systems with other staffing configurations.
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