Optimisation des soins aux urgences : analyse de pré-implémentation d’un «fast track» co-géré par un binôme médecin-infirmier de pratique avancée au CHU de Liège.

Faced with chronic overcrowding in emergency departments and a shortage of healthcare staff, new models are being developed to improve patient flow and quality of care. Among them, the «Fast Track» (FT) system, co-managed by a physician-advanced practice nurse (APN) duo, represents an innovative approach still rarely explored in Belgium. This study, conducted at the University Hospital of Liège, aimed to assess the feasibility of such a model prior to implementation. A total of 28 professionals from both hospital sites (Sart-Tilman and Notre-Dame des Bruyères) participated in semi-structured interviews. The analysis, guided by the Consolidated Framework for Implementation Research (CFIR), structured the factors influencing implementation. Approximately 25 elements were identified, including 8 facilitators, 8 barriers, and 9 ambivalent aspects. Participants expressed a generally positive perception of the FT model, emphasizing its flexibility, potential to improve patient management, and recognition of advanced nursing competencies. However, the absence of a clear legal framework, limited resources, and tensions regarding professional roles emerged as significant barriers. Overall, the physician-APN Fast Track appears to be a promising innovation, but its successful implementation will require structured change management, clear role definition, and strong institutional support.