{"id": "e58dacd", "room": "c845555", "text": "Beds are full because nobody can be discharged", "url": "https://truecauses.org/c/c845555/e58dacd-beds-discharged", "json": "https://truecauses.org/c/c845555/e58dacd.json", "embed": "https://truecauses.org/embed/c845555/e58dacd", "room_url": "https://truecauses.org/d/c845555", "question": "Why are waits in the emergency department so long?", "kind": "barriers", "relation": "significantly influences", "source": "walkthrough", "demonstration": true, "room_is": "a walkthrough with stand-ins — a demonstration, not a finding", "stands": false, "stage": 6, "sealed": true, "root": true, "shortlisted": true, "leads_to": ["6dc3cad", "bac86ec"], "comes_from": ["43cb726", "50fe52d", "b871302"], "links": [{"pair": "31a4049>e58dacd", "role": "effect", "other": {"id": "31a4049", "text": "Patients come here because they cannot get an appointment", "url": "https://truecauses.org/c/c845555/31a4049-patients-appointment"}, "verdict": "no", "by": "panel", "votes": {"yes": 1, "no": 13, "abstain": 0}}, {"pair": "3cc415f>e58dacd", "role": "effect", "other": {"id": "3cc415f", "text": "Nobody measures whether the patient got better", "url": "https://truecauses.org/c/c845555/3cc415f-measures-patient"}, "verdict": "no", "by": "panel", "votes": {"yes": 2, "no": 11, "abstain": 1}}, {"pair": "43cb726>e58dacd", "role": "effect", "other": {"id": "43cb726", "text": "Nobody may discharge at night, so a bed is lost for twelve hours", "url": "https://truecauses.org/c/c845555/43cb726-discharge-night-bed-lost-hours"}, "verdict": "yes", "by": "panel", "votes": {"yes": 11, "no": 2, "abstain": 1}}, {"pair": "50fe52d>e58dacd", "role": "effect", "other": {"id": "50fe52d", "text": "We have had four reorganisations and no more beds", "url": "https://truecauses.org/c/c845555/50fe52d-reorganisations-beds"}, "verdict": "yes", "by": "panel", "votes": {"yes": 13, "no": 1, "abstain": 0}}, {"pair": "6dc3cad>e58dacd", "role": "effect", "other": {"id": "6dc3cad", "text": "Social care and the hospital are funded from different budgets", "url": "https://truecauses.org/c/c845555/6dc3cad-social-care-hospital-funded-budgets"}, "verdict": "no", "by": "panel", "votes": {"yes": 1, "no": 11, "abstain": 2}}, {"pair": "8c6526f>e58dacd", "role": "effect", "other": {"id": "8c6526f", "text": "Experienced staff leave and take the workarounds with them", "url": "https://truecauses.org/c/c845555/8c6526f-experienced-staff-leave-workarounds"}, "verdict": "no", "by": "panel", "votes": {"yes": 0, "no": 13, "abstain": 1}}, {"pair": "a6ea3ec>e58dacd", "role": "effect", "other": {"id": "a6ea3ec", "text": "Two systems hold the same patient under different numbers", "url": "https://truecauses.org/c/c845555/a6ea3ec-systems-hold-patient"}, "verdict": "no", "by": "panel", "votes": {"yes": 0, "no": 14, "abstain": 0}}, {"pair": "b871302>e58dacd", "role": "effect", "other": {"id": "b871302", "text": "A decision to admit waits for a consultant round in the morning", "url": "https://truecauses.org/c/c845555/b871302-decision-admit-waits-consultant-morning"}, "verdict": "yes", "by": "panel", "votes": {"yes": 10, "no": 2, "abstain": 2}}, {"pair": "bac86ec>e58dacd", "role": "effect", "other": {"id": "bac86ec", "text": "People wait hours in a corridor before anyone sees them", "url": "https://truecauses.org/c/c845555/bac86ec-people-wait-hours-corridor"}, "verdict": "no", "by": "cross-group", "votes": {"yes": 8, "no": 19, "abstain": 2}}, {"pair": "e58dacd>31a4049", "role": "cause", "other": {"id": "31a4049", "text": "Patients come here because they cannot get an appointment", "url": "https://truecauses.org/c/c845555/31a4049-patients-appointment"}, "verdict": "no", "by": "panel", "votes": {"yes": 1, "no": 12, "abstain": 1}}, {"pair": "e58dacd>3cc415f", "role": "cause", "other": {"id": "3cc415f", "text": "Nobody measures whether the patient got better", "url": "https://truecauses.org/c/c845555/3cc415f-measures-patient"}, "verdict": "no", "by": "panel", "votes": {"yes": 0, "no": 12, "abstain": 2}}, {"pair": "e58dacd>43cb726", "role": "cause", "other": {"id": "43cb726", "text": "Nobody may discharge at night, so a bed is lost for twelve hours", "url": "https://truecauses.org/c/c845555/43cb726-discharge-night-bed-lost-hours"}, "verdict": "no", "by": "panel", "votes": {"yes": 1, "no": 11, "abstain": 2}}, {"pair": "e58dacd>50fe52d", "role": "cause", "other": {"id": "50fe52d", "text": "We have had four reorganisations and no more beds", "url": "https://truecauses.org/c/c845555/50fe52d-reorganisations-beds"}, "verdict": "no", "by": "panel", "votes": {"yes": 2, "no": 12, "abstain": 0}}, {"pair": "e58dacd>6dc3cad", "role": "cause", "other": {"id": "6dc3cad", "text": "Social care and the hospital are funded from different budgets", "url": "https://truecauses.org/c/c845555/6dc3cad-social-care-hospital-funded-budgets"}, "verdict": "yes", "by": "panel", "votes": {"yes": 13, "no": 1, "abstain": 0}}, {"pair": "e58dacd>8c6526f", "role": "cause", "other": {"id": "8c6526f", "text": "Experienced staff leave and take the workarounds with them", "url": "https://truecauses.org/c/c845555/8c6526f-experienced-staff-leave-workarounds"}, "verdict": "no", "by": "panel", "votes": {"yes": 1, "no": 11, "abstain": 2}}, {"pair": "e58dacd>a6ea3ec", "role": "cause", "other": {"id": "a6ea3ec", "text": "Two systems hold the same patient under different numbers", "url": "https://truecauses.org/c/c845555/a6ea3ec-systems-hold-patient"}, "verdict": "no", "by": "panel", "votes": {"yes": 2, "no": 12, "abstain": 0}}, {"pair": "e58dacd>b871302", "role": "cause", "other": {"id": "b871302", "text": "A decision to admit waits for a consultant round in the morning", "url": "https://truecauses.org/c/c845555/b871302-decision-admit-waits-consultant-morning"}, "verdict": "no", "by": "panel", "votes": {"yes": 1, "no": 13, "abstain": 0}}, {"pair": "e58dacd>bac86ec", "role": "cause", "other": {"id": "bac86ec", "text": "People wait hours in a corridor before anyone sees them", "url": "https://truecauses.org/c/c845555/bac86ec-people-wait-hours-corridor"}, "verdict": "yes", "by": "panel", "votes": {"yes": 11, "no": 2, "abstain": 1}}], "atlas": {"id": "n4b110c58fe80fe93", "url": "https://truecauses.org/atlas?q=Beds%20are%20full%20because%20nobody%20can%20be%20discharged"}, "note": "a group’s judgement, not a measurement. Demo room", "attribution": "Causal map: True Causes, https://truecauses.org/d/c845555"}