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Illness And Wait Time

Sarah Stankiewicz, Craig Larsen, Francesca Sullivan, Cristina Zullo, Suzanne C Pugh, Miroslav Kopp
BACKGROUND: ED boarding is a major issue in many hospitals. ED boarding occurs when there is insufficient hospital capacity to supply inpatient beds for admitted patients. ED boarding is not only a problem because of increased wait times for patients but also because it results in delays in administration of medication, higher rates of complications, and increased mortality. METHODS: In an attempt to improve patient flow and reduce time spent in the emergency department for patients requiring admission to the surgical intensive care unit (SICU), the emergency department, trauma service, and SICU collaborated on a guideline...
December 11, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
H X Shi, J Z Wu, G B Chen, B Z Zhu, W Y Yan, L Chen, Y J Xiao, L Y Zhang
Objective: To assess the effectiveness in optimizing resources and shortening critical children's waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination...
December 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Daria J O'Reilly, Gord Blackhouse, Sheri Burns, James M Bowen, Natasha Burke, Jeff Mehltretter, Nancy M Waite, Sherilyn Kd Houle
Objective: The aim of this study was to evaluate the impact of pharmacist administration of influenza vaccine in Ontario on: 1) vaccination-associated costs related to the number of people vaccinated; 2) annual influenza-related outcomes and costs; and 3) change in productivity costs. Methods: Using available data for Ontario, the total number of vaccinations given by providers in the 2011/12 influenza season (pre) was compared to the 2013/14 influenza season (post)...
2018: ClinicoEconomics and Outcomes Research: CEOR
Kapil Dev Soni, Gaurav Kaushik, Amit Gupta, Vishwajeet Singh, Subodh Kumar, Sushma Sagar
Introduction: Emergency department (ED) overcrowding with critically ill trauma patients has been a major concern globally. It has been shown that longer stays in the hospital before Intensive Care Unit (ICU) admission have a higher mortality rate. Objective: The objective of this study was to find whether the delay in ICU admission from ED is associated with significant mortality in a trauma patient. Methods: A prospective trauma registry data of 232 patients collected from the ED of JPNATC trauma center between September 2015 and March 2016 were used in the study...
July 2018: Journal of Emergencies, Trauma, and Shock
Mohsen Saidinejad, Audrey Paul, Marianne Gausche-Hill, Dale Woolridge, Alan Heins, William Russell Scott, Phillip Friesen, David Rayburn, Gregory Conners, Emory Petrack, Timothy Horeczko, Michael Stoner, Elizabeth Edgerton, Madeline Joseph
This article provides recommendations for pediatric readiness, scope of services, competencies, staffing, emergency preparedness, and transfer of care coordination for urgent care centers (UCCs) and retail clinics that provide pediatric care. It also provides general recommendations for the use of telemedicine in these establishments.With continuing increases in wait times and overcrowding in the nation's emergency departments and the mounting challenges in obtaining timely access to primary care providers, a new trend is gaining momentum for the treatment of minor illness and injuries in the form of UCCs and retail clinics...
November 12, 2018: Pediatric Emergency Care
Fitsum Sebsibe Teni, Begashaw Melaku Gebresillassie, Eshetie Melese Birru, Sewunet Admasu Belachew, Yonas Getaye Tefera, Befikadu Legesse Wubishet, Bethelhem Hailu Tekleyes, Bilal Tessema Yimer
BACKGROUND: Out-of-pocket expenditure constitutes high proportion of healthcare spending in low-income countries. It can affect patients' adherence to treatments leading to serious health consequences. The objective of this study was to document costs incurred by patients visiting Gondar University Referral Hospital, in Gondar, northwestern Ethiopia. METHODS: An institution-based cross-sectional study was conducted among 346 outpatients at the hospital from 2nd to 20th of May 2016...
November 8, 2018: BMC Health Services Research
Molly K Crossman, Alan E Kazdin, Angela Matijczak, Elizabeth R Kitt, Laurie R Santos
Interactions with animals represent a promising way to reduce the burden of childhood mental illness on a large scale. However, the specific effects of child-animal interactions are not yet well-established. This study provides a carefully controlled demonstration that unstructured interactions with dogs can improve clinically relevant symptoms in children. Seventy-eight children (55.1% female, 44.9% male) ages 10 to 13 (M = 12.01, SD = 1.13) completed the Trier Social Stress Test for Children, followed by (a) interaction with a dog, (b) a tactile-stimulation control condition, or (c) a waiting control condition...
October 30, 2018: Journal of Clinical Child and Adolescent Psychology
M A Zimmerman, M Selim, J Kim, M Kozeniecki, J C Hong
The current organ crisis has led to prolonged waiting times for liver transplantation, the progression of liver disease, and the subsequent increase in severity of illness. High acuity patients in need of orthotopic liver transplantation (OLT) maybe denied access to life-saving transplantation due to perceived poor outcomes after OLT and severe comorbid conditions. Recent studies demonstrated the highest survival benefit and acceptable post-OLT outcomes in high-acuity patients. This article provides an overview of a transplantation critical care model to increase liver transplantation access and optimize post-OLT outcomes in high-acuity patients...
November 2018: Transplantation Proceedings
Darryn Marks, Tracy Comans, Leanne Bisset, Michael Thomas, Paul A Scuffham
Objective The aim of this study was to calculate the societal economic burden of shoulder pain in patients on the orthopaedic waiting list at an Australian public hospital and calculate the cost (from the government's perspective) of care delivered by the hospital for those patients. Methods A cost-of-illness analysis was undertaken in a cohort of 277 orthopaedic patients on the Gold Coast in Australia. Outcomes included a health care costs and impacts questionnaire, work absenteeism, presenteeism questionnaires (Work Limitations Questionnaire (WLQ) and Work Productivity and Activity Impairment Questionnaire (WPAI)) and hospital care provision over a 2-year period...
October 15, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Pallavi Dham, Neeraj Gupta, Jacob Alexander, Warwick Black, Tarek Rajji, Elaine Skinner
BACKGROUND: Evaluation of telepsychiatry (via videoconference) for older adults is mostly focussed on nursing homes or inpatients. We evaluated the role of a community based program for older adults in rural and remote regions of South Australia. METHOD: The utilization pattern was studied using retrospective chart review of telepsychiatry assessments over 24 months (2010-2011). Satisfaction was evaluated through prospective post-consultation feedback (using a 5-point Likert scale), from patients, community based clinicians and psychiatrist participating in consecutive assessments from April-November 2012...
September 27, 2018: BMC Psychiatry
Laura Lai, Robert G Bota
Objective: Older adults with complicated illnesses such as Alzheimer's disease often require specialized treatment in geriatric facilities when inpatient psychiatric hospitalization is needed. However, there is a shortage of these inpatient facilities. Thus, patients could wait in the emergency department (ED) for days pending availability of a bed at an appropriate facility. The objective of this study was to quantify that wait time. Methods: Records for patients aged 60-89 years who were seen in the ED and had a psychiatric consultation over a 2-year period (July 2014 to June 2016) were reviewed...
September 20, 2018: Primary Care Companion to CNS Disorders
Salome C Erekaha, Llewellyn J Cornelius, Melissa L Bessaha, Abdulmumin Ibrahim, Gabriel D Adeyemo, Mofoluwake Fadare, Manhattan Charurat, Echezona E Ezeanolue, Nadia A Sam-Agudu
The acceptability of lifelong antiretroviral therapy (ART) among HIV-positive women in high-burden Nigeria, is not well-known. We explored readiness of users and providers of prevention of mother-to-child transmission of HIV (PMTCT) services to accept lifelong ART -before Option B plus was implemented in Nigeria. We conducted 142 key informant interviews among 100 PMTCT users (25 pregnant-newly-diagnosed, 26 pregnant-in-care, 28 lost-to-follow-up (LTFU) and 21 postpartum women living with HIV) and 42 PMTCT providers in rural North-Central Nigeria...
December 2018: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
Henrik Auråen, Hans Henrik L Schultz, Pekka Hämmäinen, Gerdt C Riise, Hillevi Larsson, Lennart Hansson, Göran Dellgren, Michael Perch, Odd Geiran, Arnt E Fiane, Martin Iversen, Are Martin Holm
BACKGROUND: Throughout the world, the scarcity of donor organs makes optimal allocation systems necessary. In the Scandiatransplant countries, organs for lung transplantation are allocated nationally. To ensure shorter wait time for critically ill patients, the Scandiatransplant urgent lung allocation system (ScULAS) was introduced in 2009, giving supranational priority to patients considered urgent. There were no pre-defined criteria for listing a patient as urgent, but each center was granted only 3 urgent calls per year...
December 2018: Journal of Heart and Lung Transplantation
Ryan W Haines, Christopher J Kirwan, John R Prowle
PURPOSE OF REVIEW: Continuous renal replacement therapy (CRRT) is now the mainstay of renal organ support in the critically ill. As our understanding of CRRT delivery and its impact on patient outcomes improves there is a focus on researching the potential benefits of tailored, patient-specific treatments to meet dynamic needs. RECENT FINDINGS: The most up-to-date studies investigating aspects of CRRT prescription that can be individualized: CRRT dose, timing, fluid management, membrane selection, anticoagulation and vascular access are reviewed...
December 2018: Current Opinion in Critical Care
Frédéric Ehrler, Christian Lovis, Jessica Rochat, Franck Schneider, Alain Gervaix, Annick Galetto-Lacour, Johan N Siebert
Nowadays, citizens are little supported to decide whether they should consult the Emergency Departments (ED) in case of illness or trauma. Moreover, once in the ED, they often must deal with overcrowding, long waiting times, the acute nature of the visits, administrative data management, and a lack of follow-up after the visit. To improve this situation, we have developed an e-health solution delivering a more patient-centered experience by connecting patients, caregivers, and administrative clerks through a web and mobile applications...
September 5, 2018: Revue Médicale Suisse
Taurayi A Tafuma, Nyikadzino Mahachi, Chengetai Dziwa, Tafara Moga, Paul Baloyi, Gladys Muyambo, Auxilia Muchedzi, Tinashe Chimbidzikai, Getrude Ncube, Joseph Murungu, Tendai Nyagura, Katherine Lew
Background: The emergence of antiretroviral therapy (ART) transformed HIV from a terminal illness to a chronic disease. However, limited access to health services remains one of many barriers to HIV service utilisation by people living with HIV (PLHIV) in low-resource settings. The goal of this study was to describe the barriers to HIV service utilisation in two provinces of Zimbabwe. Methods: A qualitative descriptive study was conducted with PLHIV and village health workers (VHW) in eight districts within the two provinces...
2018: Southern African Journal of HIV Medicine
Apichai Wattanapisit, Udomsak Saengow
Background: A universal health coverage policy was implemented in Thailand in 2002 and led to an increase in accessibility to, and equity of, healthcare services. The Thai government and academics have focused on the large-scale aspects, including effectiveness and impacts, of universal health coverage over one decade. Here, we aimed to identify patients' perspectives on hospital visits under universal health coverage. Methods: A qualitative study was carried out in four public hospitals in rural Thailand...
2018: Asia Pacific Family Medicine
Ugenthiri Naiker, Gerry FitzGerald, Joel M Dulhunty, Michael Rosemann
Objective. The delivery of public out-patient services is an essential part of complex healthcare systems, but the contribution of public out-patient services is often ill defined and poorly evaluated. The aim of this study was to identify and better understand those factors that may affect the performance of out-patient services to provide health service managers, clinicians and executives with a conceptual framework for future decision-making processes. Methods. The present qualitative research involved five exploratory case studies...
August 20, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Melissa Henry, Yu Chang, Saul Frenkiel, Gabrielle Chartier, Richard Payne, Christina MacDonald, Carmen Loiselle, Martin J Black, Alex M Mlynarek, Antoinette Ehrler, Zeev Rosberger, Michael Tamilia, Michael P Hier
PURPOSE: To offer a better understanding of the experiences, preferences, and needs of patients with thyroid cancer. PARTICIPANTS & SETTING: 17 patients with thyroid cancer receiving treatment at a university-affiliated hospital in Montreal, Québec, Canada. METHODOLOGIC APPROACH: Interviews were conducted with patients, and descriptive phenomenology was used to explore patients' lived experience. FINDINGS: Coping with uncertainty was a major theme that emerged from interviews, with some of the main concerns being difficult treatment decisions, long surgery wait times, and fears about surgical complications, potential metastases, and death...
September 1, 2018: Oncology Nursing Forum
Hiran Thabrew, Karolina Stasiak, Sarah E Hetrick, Stephen Wong, Jessica H Huss, Sally N Merry
BACKGROUND: Long-term physical conditions affect 10% to 12% of children and adolescents worldwide; these individuals are at greater risk of developing psychological problems, particularly anxiety and depression. Access to face-to-face treatment for such problems is often limited, and available interventions usually have not been tested with this population. As technology improves, e-health interventions (delivered via digital means, such as computers and smart phones and ranging from simple text-based programmes through to multimedia and interactive programmes, serious games, virtual reality and biofeedback programmes) offer a potential solution to address the psychological needs of this group of young people...
August 15, 2018: Cochrane Database of Systematic Reviews
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