liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Turfing in the emergency department
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care in Linköping.
2014 (English)In: EMERGENCIAS, ISSN 1137-6821, Vol. 26, no 2, 129-132 p.Article in journal (Refereed) Published
Abstract [en]

Background and objective: Turfing, defined as finding any excuse to refer a patient to a different department or team, is commonly done to avoid patient admission. Research on turfing is limited, and the practice is rarely spoken about. The author has sometimes experienced difficulty obtaining radiology images because of a stringent policy of avoiding doing such tests out of regular office hours. I suspected that physicians may present patients symptoms in ways that imply certain medical conditions, in other words to "optimize" the patient according to the criteria needed for the investigation asked for. In this study, I explored the presence and extent of turfing and optimizing in a Swedish emergency department (ED). Method: The emergency physicians (EP) at a tertiary care university hospital were invited to participate in an anonymous intranet-based survey. Demographic data collected were the physicians total experience (years), the total number of patients treated, and the experience within the present hospital (years). The EP were asked about their experience of turfing and optimizing and the percentage of patients to whom these practices were applied. The respondents were also asked how they viewed turfing and optimizing and how they thought these practices affected ED wait times. Results: Responses were received from 18 EP with a mean (SD) of 11.5 (8.48) years of total experience and of 4.4 (3.73) years in the present hospital (62% response rate). The majority had treated more than 5000 patients. All respondents confirmed the practice of turfing, and it was estimated that turfing was used in 17.34% (13.08%) of all patients (range, 2%-50%). Seventeen of the 18 respondents felt obliged to optimize patients to get tests performed, estimating that 23.23% (22.97%) of their patients were affected (range, 5%-80%). Twelve regarded turfing and optimizing to be unsafe and 17 believed that these practices influenced ED wait times. Conclusion: Turfing and optimizing, affecting approximately 1 in 5 emergency patients in this setting, seem to be major problems for the surveyed Swedish EP.

Place, publisher, year, edition, pages
SANIDAD EDICIONES , 2014. Vol. 26, no 2, 129-132 p.
Keyword [en]
Turfing; Optimizing; Emergency department; Physicians experience
National Category
Clinical Medicine Health Sciences
URN: urn:nbn:se:liu:diva-106123ISI: 000333001900009OAI: diva2:714043
Available from: 2014-04-25 Created: 2014-04-24 Last updated: 2015-03-23

Open Access in DiVA

No full text

Other links

Link to Journal

Search in DiVA

By author/editor
Schilling, Ulf Martin
By organisation
Division of Clinical SciencesFaculty of Health SciencesDepartment of Acute Health Care in Linköping
Clinical MedicineHealth Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Total: 116 hits
ReferencesLink to record
Permanent link

Direct link