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Summary of countrywide supervision in 2007 of accident and emergency units in specialized health services – are services of adequate quality and do they meet legislative requirements?

In 2007 the Norwegian Board of Health Supervision in the Counties carried out supervision of 28 of the 53 accident and emergency units within specialized health services in Norway. The theme of supervision was whether the quality of these services is adequate, and whether these services are provided in accordance with legislative requirements.

The management of the health trusts have responsibility for ensuring that daily tasks are planned, organized, carried out and improved in accordance with legislative requirements. Reception, prioritization, examination, diagnosis, monitoring and treatment of patients in accident and emergency units shall be in line with sound professional standards. The main aim of supervision of these services was to investigate whether health trusts fulfil their responsibilities, and how they do this.

The Norwegian Board of Health Supervision has found that, in general, inadequate management and leadership affects the day-to-day running of these services. In most of the accident and emergency units where supervision was carried out, much of the day-to-day activities depended on competent individuals who “rolled up their sleeves” and stretched themselves to the limit to find solutions to problems related to awkward situations, everyday crises and bottlenecks in the system. The general picture seems to be that ad-hoc solutions rather than systematic management prevent stressful situations from developing into adverse events and deficiencies in the services.