Danish Emergency Medical Care is Changing

Danish emergency medical care is undergoing the largest reorganisation in decades. The number of acute hospitals have been reduced from 40+ to 21 and the new emergency departments which differ in organisation design are being established. The emergency departments play an important role in the planning of future hospitals, including controlling hospital crowding, since up to 70 % of all patients are evaluated in the emergency departments to determine if they can be treated and discharged without further admission. How the differences in organisation impact efficiency, effectiveness, quality of patient care, and resource utilization is unknown. 

Purpose of DESIGN-EM

The purpose of the Research Network for Organisation Design and Emergency Medicine, DESIGN-EM, is, to bring together state-of-the-art expertise in emergency medicine and quality of patient care with state-of-the-art expertise on how to design effective and efficient organisations on the basis of data analytics combined with innovative developments in software that can support the practical implementation of the research results.

Similar trends and challenges for the emergency departments are seen internationally, and DESIGN-EM therefore includes international and corporate partners with recognised experience in innovative and research-based solutions for healthcare.

Outcomes of DESIGN-EM

The network will offer new knowledge and innovative solutions to the challenges of organising emergency medical care in the face of demographic changes and a demand for reducing healthcare costs. The results contribute to insuring future equal access to high quality patient-centered health care –when it is needed the most in the emergency situation.

DESIGN-EM contributes to optimising Danish healthcare by developing new organisational, technological, and financial solutions making better use of existing resources and ensuring coordination of procedures and services and, for the benefit of patients, employees, as well as collaborative partners and society as a whole.

What is DESIGN-EM?

DESIGN-EM is a cross-disciplinary research network that combines research-based knowledge about optimising organisation design with the emergency medicine field in order to give evidence-based guidelines for designing effective and efficient emergency departments.

The founding partners are Research Center for Emergency Medicine (CfA), Aarhus University Hospital and Interdisciplinary Center for Organisational Architecture (ICOA), Aarhus University.

What is Organisation Design?

Organisational efficiency and effectiveness is largely determined by the choice of an organisation design. Organisation design is the design of structures and processes, including, but not exclusively, workflow, use of data and information, incentives structure, and staffing.

What is Emergency Medicine?

Emergency Medicine is concerned with the initial stabilization, management, diagnosis, and disposition of individuals with acute illness and injury. Emergency Medicine encompasses a large amount of general medicine but involves the technical and cognitive aspects of virtually all fields of medicine and surgery. Emergency Medicine is a medical specialty in many countries around the world including Sweden and Finland.

COVID-19 report May 2022

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DESIGN-EM status report 2018-2021

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DESIGN-EM status report 2013-2017

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Gitte Boier Tygesen: Development and evaluation of a situation awareness model targeting clinical deterioration in the Emergency Department

Line Stjernholm Tipsmark: Organizational Design of Emergency Departments: Policy evaluation

Iben Duvald Pedersen: Exploring and explaining the weekend effect in a Danish emergency department  

Anders Møllekær: The organization of Danish emergency departments and patient outcome 

Henrike Konzag: Use of Information Systems Across Tasks and Shifts: An Analysis of Two Hospital Emergency Units 


2021 Duvald, I.: Using action research and organization design to plan in-home hospital treatment. Research in Organizational Change and Development vol 29:111-142

2021 Duvald, I.: When methods play each other good. A reflection on how anthropology and action research can be combined. Jordens Folk 56(2):81-93

2021 Duvald, I., Konzag, H. & B. Obel: The importance of organizational design for the quality of patient care. Oekonomi & Politik (3).

2021 Tygesen GB, Lisby M, Raaber N, Rask MT, Kirkegaard H. A new situation awareness model decreases clinical deterioration in the emergency departments - A controlled intervention study. Acta Anaesthesiol Scand.

2020 Tygesen GB, Kirkegaard H, Raaber N, Rask MT, Lisby M. Consensus on predictors of clinical deterioration in emergency departments: A Delphi process study. Acta Anaesthesiol Scand. 65:266-275.

2019 Duvald, I.: Exploring reasons for the weekend effect in a hospital emergency department: An information processing perspective. Journal of Organization Design.

2019 Møllekær, A., Kirkegaard, H., Vest-Hansen, B., Duvald, I., Eskildsen, J., Obel, B. & B. Madsen: Risk of death within 7 days of discharge from emergency departments with different organizational models. European Journal of Emergency Medicine. Published Ahead-of-Print. 

2018 Duvald, I., Møllekær, A., Boysen, M.A. & B. Vest-Hansen: Linking the severity of illness and the weekend effect. A cohort study examining emergency department visits. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 26(72). 

2018 Møllekær, A., Duvald, I., Obel, B., Madsen, B., Eskildsen, J.K. & H. Kirkegaard: The organisation of Danish emergency departments. European Journal of Emergency Medicine. Published Ahead-of-Print.