Content Anlysis

¶ … Anlysis

The first document is a description of the Tacoma General Hospital Emergency Department, while the second document characterizes quantitatively (number of resources and capacities) and qualitatively the Adult Trauma Service, designed to service the traumas and critical cases that occur in the Pierce County and the West Region of Washington State.

Analysis of document structure

The Tacoma document starts with a description of the different components and units of the General Hospital. Despite the fact that it is entitled description of program/service, it is not really that, but simply an enumeration of the facilities and instruments, including the electronic devices available (fax capabilities, TDY phone for hearing impaired individuals), rooms and medical facilities.

The second distinctive sub-chapter divides the population served by two criteria: age and common diagnosis. The goal of this sub-chapter is for the department to define its mission target (although the mission is not necessarily explained in the first paragraph, as it should have probably been) and to create indications on what kind of patients should find their way to the emergency department.

The 3rd sub-chapter is a "user's guide," used to sum up the rules governing the activity of the department and to communicate to the public what the department's policies are in issues ranging from brain death to admission criteria and to the basic procedures that will be applied to the patient as long as he is in this department. It should provide an overall approach to what the patient should be entitled to and what he should expect while in the department.

The hours of operation sub-chapter simply specifies that the department provides care 24 hours a day. The following sub-chapters refer to the human resources available and their capacities. This is an exhaustive qualitative approach that includes information on the professionals' activities etc. As such, a staffing plan is provided, along with the core competencies of each of the staff members. The professional standards by which the department abides are presented.

The second document, referring to the Adult Trauma Service, starts with an explicit mention of the organization's mission, which is to "to provide top quality trauma care and coordinate sub-specialty trauma care for injured patients from Pierce county, and to serve as a regional resource for injured patients in a five county area." The mission statement gives an excellent background on both the services provided and the targeted geographical area, all in these lines. The scope and mission is later developed to include general characteristics of the operating unit, such as the operation hours (24 hours a day, 7 days a week), the explicit definition of a trauma patient etc.

Sub-chapters 2 and 3 develop on the targeted patients introduced in the 1st paragraph. As such, the list of diagnostics is presented, with the age groups served shown in the 3rd sub-chapter. Additionally, the department's document provides limitations to services it provides, something absent from the previous document.

Finally, the last sub-chapter deals with staffing. Comparative to the previous document analyzed, this document provides exclusively a quantitative approach to the staffing issue that includes only the number of individuals employed in each position rather than additional information.

The common theme for both documents is description. Indeed, both of these documents are documents meant to describe qualitative and quantitative characteristics related to the activity, the personnel they use in this activity and the general rule framework guiding the activity. On the other hand, despite the fact that both of the documents are similar in many of the elements that are chosen for the presentation, there are elements missing in one case, as in the other.

First of all, the trauma document is exhaustive in the description of its mission and scope. We can agree that this is an important element that would characterize its activity and, additionally, the mission and scope also includes reference to the targeted population for these services.

On the other hand, the Tacoma General Hospital Emergency Department document lacks reference to its specific mission or goal, despite the fact that this can be deduced from the analysis of the different sub-chapter.

It rather presents a summary of the instruments and facilities available and continues with the two important criteria to determine patients who are subjected to these services (age and common diagnoses).

The Adult Trauma Service chooses to include part of the description of the serviced population in its mission and scope purpose, but continues to detail on this with the exact same criteria used by the Emergency Department (diagnostic groups and age groups served). However, the mention of the geographic area of activity of the Emergency Department helps in delimiting the geographical area in which the services are available, thus introducing a third additional descriptive dimension in use here. The Emergency Department makes no clear mention of its geographic location, although it refers to being in the State of Washington (this is comparative to a distinct sentence in the case of the Trauma Center limiting the services to Pierce County and the five county area).

The last thing described in the content of both documents is the staffing. The staffing description can be both quantitative and qualitative. While the Trauma Center document presents an exclusively quantitative description, the Emergency Department staff description is less quantitative and more qualitative, briefly referring to the quantitative structure of the staff in order to emphasize more on the skill requirements and the staff capacities.

As such, the description of the staffing includes a list of responsibilities and the staffing pattern, along with a descriptive table of the competencies in each of the cases of the staff members. The table is visual, placing on the rows the positions on the staff and in the columns, the competencies available, with Xs to tick the appropriate competencies for the appropriate position.

The Trauma Center is simple in listing the number of positions currently occupied and in showing the structure of the staff in terms of physicians, nurses, administrators etc.

The Emergency Department has additional information on (1) code of conduct and general rules, (2) the professional standards by which the staff adheres and (3) the MHS and unit references used. The code of conduct is exhaustive in providing a general set of rules and regulations that can be applied in different potential situations. This goes from discharge to transfer or brain death. The role of this code of rules and conduct is to provide the necessary framework by which a decision can be made in a certain situation. In hope of covering all potential situations, this subchapter has been extended over one and a half pages, while it is more or less missing completely (despite bits and pieces across the other subchapters) in the other document.