Existence and role of standard operating procedures in the emergency department

A national online survey
  • Benjamin LucasEmail author
  • Wiebke Schirrmeister
  • Gerald Pliske
  • Michael Leenen
  • Felix Walcher
  • Carsten Kopschina



In recent years, increases in the number of patients in emergency departments (ED) have led to continuous work intensification. To handle this problem, the treatment effectiveness has to be maximized. One strategy that may help to optimize workflow is the use of standard operating procedures (SOPs). We investigated the existence of SOPs and subjective effects on treatment in German EDs.


We performed an online survey from February 2015 until June 2016. We collected data regarding the existence of SOPs, health care level, medical field, work experience, and education. All professional groups participating in the treatment of patients were requested to take part in the survey.


Seventy-five percent of the 589 participants in the survey confirmed the existence of SOPs in their EDs. SOPs were more frequently available in hospitals with higher health care levels. Participants working in EDs without SOPs felt less confident regarding treatment of patients. More than 85% of these participants were in favor of having SOPs. The absence of SOPs was associated with a subjective delay in patient treatment.


Most of the EDs had available SOPs. In departments without SOPs, most physicians wanted them to be implemented. SOPs seemed adequate in terms of supporting workflow and satisfaction with patients’ treatment.


Clinical pathways Emergency department Health care level Health care survey Overcrowding 

Vorliegen und Rolle von Standard Operating Procedures in der Notaufnahme

Eine nationale Onlineumfrage



Die in den letzten Jahren steigende Zahl an Patienten in den Notaufnahmen führte zu einer zunehmenden Arbeitsverdichtung. Um dieses Problem zu adressieren, muss u. a. die Behandlungseffektivität gesteigert werden. Eine Strategie ist die Optimierung des Workflows durch die Nutzung von Standard Operating Procedures (SOP). Wir untersuchten die Häufigkeit von SOP und deren subjektive Effekte auf die Patientenbehandlung in deutschen Notaufnahmen.


Wir führten von Februar 2015 bis Juni 2016 eine Onlineumfrage in deutschen Notaufnahmen durch. Dazu wurden Daten zum Vorliegen von SOP, dem Versorgungslevel des Krankenhauses sowie dem medizinischen Hintergrund, der Arbeitserfahrung und der Ausbildung des Befragten erhoben. Dabei wurden alle Professionen eingeschlossen, die an der unmittelbaren Patientenbehandlung beteiligt sind.


Von den insgesamt 589 Teilnehmern gaben 75 % an, über SOP in der Notaufnahme zu verfügen. Dabei waren SOP häufiger in Krankenhäusern mit höherem Versorgungslevel zu finden. Teilnehmer, die über keine SOP in der Notaufnahme verfügten, fühlten sich unsicherer in der Patientenbehandlung. Mehr als 85 % dieser Befragten wünschten sich SOP. Das Fehlen der SOP war weiterhin mit einer subjektiven Verzögerung der Patientenbehandlung verbunden.


Die meisten Notaufnahmen verfügen über SOP. Beim Fehlen von SOP wünschten sich die meisten dort arbeitenden Ärzte deren Implementierung. In diesem Hinblick scheinen SOP ein geeigneter Weg zu sein, den Workflow zu unterstützen und die Zufriedenheit mit der Patientenbehandlung zu verbessern.


Klinische Versorgungswege Notaufnahme Versorgungsniveau Umfrage zur Gesundheitsversorgung Überfüllung 


Compliance with ethical guidelines

Conflict of interest

B. Lucas, W. Schirrmeister, G. Pliske, M. Leenen, F. Walcher, and C. Kopschina declare that they have no competing interests.

For this article no interventional studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case. This anonymized online survey contained no personal data. Therefore, ethics approval was not necessary.

Supplementary material

63_2019_642_MOESM1_ESM.pdf (398 kb)
English translation of the questionnaire aimed at all professional groups working in the emergency department. The survey was used to record a status quo on the use and availability of SOPs in German emergency departments as well as context factors such as the health care level of the hospital, specialization of the physicians, or the attitude towards SOPs.


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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Benjamin Lucas
    • 1
    Email author
  • Wiebke Schirrmeister
    • 1
  • Gerald Pliske
    • 1
  • Michael Leenen
    • 2
  • Felix Walcher
    • 1
  • Carsten Kopschina
    • 3
  1. 1.Department of Trauma SurgeryOtto-Von-Guericke University MagdeburgMagdeburgGermany
  2. 2.Emergency Department, Community Hospital Nettetal GmbHNettetalGermany
  3. 3.Department of Trauma and Orthopaedic Surgery, Hospital Lauf a.d. PegnitzKrankenhäuser Nürnberger Land GmbHLauf an der PegnitzGermany

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