Draw me an Emergency Department. How do non-Emergency Practitioners Imagine an Ideal Emergency Department?

Aim: To determine how a hospital's non-emergency practitioners imagine the ideal emergency department (ED). Procedure: We built a questionnaire on the basis of a semi-structured interview of two heads of non-emergency departments on the theme of the ideal ED. We sent this questionnaire to all of the heads of non-ED adult clinical departments of the Parisian hospital network Assistance publique-Hpitaux de Paris. Results: We received 131 answers out of the 265 questionnaires sent (49%). The rate of answer per specialty ranges from 12% (stomatology) to 80% (cancerology, neurology). To the question "The ideal ED sends the patient to the specialty department that is required", 56% answered "always" and 41% "often." For 43% of respondents "the ED calls the specialist as soon as a diagnostic probability arises" but 66% say "the therapeutic care begins before the call of the specialist." For 62%, the ideal ED informs the specialist if one of the patients he/she usually takes care of is present in the ED, whatever the reason he/she attends the ED. Conclusion: Non-emergency practitioners have difficulties to shape an ideal and to put aside current deficiencies. We noticed an important diversity of expectations and sometimes contradictory answers. The only consensus that seems to emerge among the respondents is a wish for an optimal information loop between the ED and their own department and also a good training in intensive care for emergency practitioners. The diversity of answers could be seen as a confirmation that the emergency world has to pursue its efforts in defining its own standards.