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https://www.readbyqxmd.com/read/28509783/the-evaluation-of-adolescent-chest-pain-a-screening-ecg-or-psc-17
#1
Patricia E Acra, María T Pérez
PURPOSE OF REVIEW: The present review offers an update on entities presenting as chest pain in the adolescent population. It discusses recently proposed tools and shared mental models used in primary and urgent care settings to evaluate chest pain, and their focus on identifying life-threatening processes. We consider whether the current practice may be improved by accounting for the increasingly recognized non-life-threatening causes of adolescent chest pain. RECENT FINDINGS: The present experiences and behaviors of adolescents have added new causes of chest pain to the work-up of this disquieting chief complaint...
May 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28498199/incorporating-alternative-care-site-characteristics-into-estimates-of-substitutable-ed-visits
#2
Nathan Seth Trueger, Kao-Ping Chua, Aamir Hussain, Aisha T Liferidge, Stephen R Pitts, Jesse M Pines
BACKGROUND: Several recent efforts to improve health care value have focused on reducing emergency department (ED) visits that potentially could be treated in alternative care sites (ie, primary care offices, retail clinics, and urgent care centers). Estimates of the number of these visits may depend on assumptions regarding the operating hours and functional capabilities of alternative care sites. However, methods to account for the variability in these characteristics have not been developed...
May 11, 2017: Medical Care
https://www.readbyqxmd.com/read/28493626/why-do-people-choose-emergency-and-urgent-care-services-a-rapid-review-utilizing-a-systematic-literature-search-and-narrative-synthesis
#3
Joanne E Coster, Janette K Turner, Daniel Bradbury, Anna Cantrell
OBJECTIVES: Rising demand for emergency and urgent care services are well documented, as are the consequences, for example, ED crowding, increased costs, pressure on services and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions and behavioural changes relating to how people choose to access health services. The aim of this systematic mapping review is to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28487288/primary-care-services-co-located-with-emergency-departments-across-a-uk-region-early-views-on-their-development
#4
Suzanne Ablard, Colin O'Keeffe, Shammi Ramlakhan, Suzanne M Mason
BACKGROUND: Co-location of primary care services with Emergency Departments (ED) is one initiative aiming to reduce the burden on EDs of patients attending with non-urgent problems. However, the extent to which these services are operating within or alongside EDs is not currently known.This study aimed to create a typology of co-located primary care services in operation across Yorkshire and Humber (Y&H) as well as identify early barriers and facilitators to their implementation and sustainability...
May 9, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28481843/vha-patient-centered-medical-home-associated-with-lower-rate-of-hospitalizations-and-specialty-care-among-veterans-with-posttraumatic-stress-disorder
#5
Ian Randall, David C Mohr, Charles Maynard
OBJECTIVE: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). METHODS: VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28473509/why-do-patients-seek-primary-medical-care-in-emergency-departments-an-ethnographic-exploration-of-access-to-general-practice
#6
Fiona MacKichan, Emer Brangan, Lesley Wye, Kath Checkland, Daniel Lasserson, Alyson Huntley, Richard Morris, Peter Tammes, Chris Salisbury, Sarah Purdy
OBJECTIVES: To describe how processes of primary care access influence decisions to seek help at the emergency department (ED). DESIGN: Ethnographic case study combining non-participant observation, informal and formal interviewing. SETTING: Six general practitioner (GP) practices located in three commissioning organisations in England. PARTICIPANTS AND METHODS: Reception areas at each practice were observed over the course of a working week (73 hours in total)...
May 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28464887/healthy-families-study-protocol-for-a-randomized-controlled-trial-of-a-screening-brief-intervention-and-referral-to-treatment-intervention-for-caregivers-to-reduce-secondhand-smoke-exposure-among-pediatric-emergency-patients
#7
E Melinda Mahabee-Gittens, Robert T Ammerman, Jane C Khoury, Lara Stone, Gabe T Meyers, John K Witry, Ashley L Merianos, Tierney F Mancuso, Kristin M W Stackpole, Berkeley L Bennett, Laura Akers, Judith S Gordon
BACKGROUND: Involuntary exposure to secondhand smoke (SHSe) is an important cause of morbidity in children who present to the pediatric emergency department (PED) and urgent care (UC). SHSe interventions delivered in the PED and UC would benefit both the smoker and child, but there have been no large trials testing the efficacy of such interventions. The Healthy Families program is the first randomized controlled trial to test whether a screening, brief intervention, and referral to treatment (SBIRT) intervention delivered in the PED and UC will be effective in decreasing SHSe in children and increasing cessation in smokers...
May 2, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28464172/initial-experience-of-a-primary-urgent-care-clinic-curriculum-and-subspecialty-lectureship-series-implementation-in-a-los-angeles-county-hospital
#8
Harsh Agrawal, Anna Martinez, Elizabeth R Volkmann, Oleg Melamed, Soma Wali
OBJECTIVES: Urgent care clinics are extremely busy in the University of California-Los Angeles (UCLA) County hospital system. We determined that residents and medical students in the internal medicine residency program who are rotating through these clinics did not receive enough teaching during their rotation. We decided to create and implement an urgent care curriculum and lectures to help achieve structure for the rotation. The goal of this series was to educate and assist residents in the primary care setting to comfortably manage subspecialty conditions, help reduce the already-overwhelmed county subspecialty referral system, and promote learning...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28456338/urgent-care-medicine-and-the-role-of-the-app-within-this-specialty
#9
Jessica Memmel, Marcy Spalsbury
The field of urgent care medicine offers an additional medical pathway for patients who have immediate, but non-life-threatening, medical concerns. Urgent care medicine offers a more varied set of resources and services than a physician office setting, with more flexible hours. This gives patients an opportunity to not have to go to the emergency department for non-emergent care. As a newer specialty within the medical field, certain roles of healthcare providers other than physicians are becoming established, including the advanced practice provider (APP)...
April 26, 2017: Disease-a-month: DM
https://www.readbyqxmd.com/read/28447914/diagnosis-of-life-threatening-alpha-gal-food-allergy-appears-to-be-patient-driven
#10
Mary Grace Flaherty, Samantha Jan Kaplan, Maya R Jerath
OBJECTIVE: Patients exhibiting life-threatening symptoms associated with the alpha-gal food allergy (delayed urticaria or anaphylaxis due to mammalian meat) are frequently undiagnosed, causing unnecessary emergency department (ED) and health care visits, and extensive pain and suffering. This study aimed to determine the path to diagnosis experienced by alpha-gal patients. METHODS: Semistructured interviews were conducted from March to June 2016 with a chronological systematic sample of approximately 10% of patients diagnosed with alpha-gal and treated by the University of North Carolina Allergy and Immunology Clinic (n = 28)...
April 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28447542/assessing-outcomes-of-educational-videos-in-group-visits-for-patients-with-chronic-pain-at-an-academic-primary-care-clinic
#11
Carrie Vogler, Stacy Sattovia, Laura Y Salazar, Tiffany I Leung, Albert Botchway
OBJECTIVES: This study evaluates the impact of pain education group visits on patients with chronic non-cancer pain (CNCP). The primary outcome of the study was to evaluate patients' functional status and secondary outcomes included knowledge, behavior, and satisfaction, before and after participation in the pain education group visits. METHODS: Locally produced patient educational videos on chronic non-cancer pain were delivered during patient group visits led by a healthcare provider...
April 27, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28443721/evaluation-of-surgical-outcomes-with-photoselective-greenlight-xps-laser-vaporization-of-the-prostate-in-high-medical-risk-men-with-benign-prostatic-enlargement-a-multicenter-study
#12
Emad Rajih, Come Tholomier, Pierre-Alain Hueber, Abdullah M Alenizi, Roger Valdivieso, Mounsif Azizi, Ricardo R Gonzalez, Gregg Eure, Lewis Kriteman, Mahmood Hai, Kevin C Zorn
OBJECTIVE: To evaluate the safety and short-term outcomes of photoselective vaporization of the prostate (PVP) using GreenLight XPS™ in treatment of high medical risk (HMR) men. METHODS: A multicenter retrospective analysis of 941 men who underwent PVP between August 2010 and August 2014 was performed. Patients were considered HMR if they had an American Society of Anesthesiologists physical status score ≥3. Postoperative adverse events, unexpected postoperative medical provider visits after intervention, and functional urinary outcomes were examined...
May 16, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28441225/recognizing-common-parasitic-infestations
#13
Judy Truscott, Alyssa Abebe, Kelly Donkers, Daria Segers
Parasitic infestations commonly are seen in patients in primary care, urgent care, and EDs. These infestations are a common cause of pruritus and may lead to secondary infestations. This article reviews the signs and symptoms of pinworms, lice, bedbug, and scabies infestations, as well as diagnosis and appropriate treatment.
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28436286/coordinated-asthma-program-improves-asthma-outcomes-in-high-risk-children
#14
Faye Holder-Niles, Linda Haynes, Helen D'Couto, Rebecca S Hehn, Dionne A Graham, Ann Chen Wu, Joanne E Cox
Innovative approaches within primary care are needed to reduce fragmented care, increase continuity of care, and improve asthma outcomes in children with asthma. Our objective was to assess the impact of coordinated team-based asthma care on unplanned asthma-related health care utilization. A multidisciplinary asthma team was developed to provide coordinated care to high-risk asthma patients. Patients received an in-depth diagnostic and family needs assessment, asthma education, and coordinated referral to social and community services...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#15
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28427444/interventions-to-reduce-wait-times-for-primary-care-appointments-a-systematic-review
#16
Dominique Ansell, James A G Crispo, Benjamin Simard, Lise M Bjerre
BACKGROUND: Accessibility and availability are important characteristics of efficient and effective primary healthcare systems. Currently, timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. When wait times for appointments are too long patients may experience worse health outcomes and are often left to use emergency department resources. The primary objective of our study was to systematically review the literature to identify interventions designed to reduce wait times for primary care appointments...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28426675/indicators-of-suboptimal-biologic-therapy-over-time-in-patients-with-ulcerative-colitis-and-crohn-s-disease-in-the-united-states
#17
Haridarshan Patel, Trevor Lissoos, David T Rubin
This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn's disease (CD) patients over time in the United States (US). Data from a large US claims database (2005-2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only)...
2017: PloS One
https://www.readbyqxmd.com/read/28421929/the-value-of-doing-your-best
#18
(no author information available yet)
Claire Matata is lead nurse for emergency and acute clinical research at Northumbria Specialist Emergency Care Hospital. She completed her degree in adult nursing at the University of Liverpool in 2010, and has worked in thoracic surgery, community and prison nursing and as a specialist research nurse and senior clinician in urgent care. In 2015, she spent three months in Sierra Leone during the Ebola crisis.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28403705/learning-is-everyone-s-responsibility
#19
Owen Hammett
With the pressures of delivering high-quality care to the increasing number of patients accessing emergency and urgent care, it is often difficult to ensure that we continue to learn and develop.
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28391969/urgent-care-medicine-and-the-role-of-the-advanced-practice-providers-within-this-specialty
#20
EDITORIAL
Jerrold B Leikin
No abstract text is available yet for this article.
April 6, 2017: Disease-a-month: DM
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