keyword
https://read.qxmd.com/read/38546706/evaluation-of-telehealth-services-that-are-clinically-appropriate-for-reimbursement-in-the-us-medicaid-population-mixed-methods-study
#1
JOURNAL ARTICLE
Sanjeev Saravanakumar, Andrey Ostrovsky
BACKGROUND: When the US Department of Health and Human Services instituted a State of Public Health Emergency (PHE) during the COVID-19 pandemic, many telehealth flexibilities were fast-tracked to allow state Medicaid agencies to reimburse new specialty services, sites of care, and mediums such as FaceTime to communicate with patients.. This resulted in expanded access to care for financially vulnerable Medicaid patients, as evidenced by an uptick in telehealth use. Research has mostly focused on telehealth reimbursement for limited use cases such as rural primary care, without broader consideration for how telehealth can be appropriately mainstreamed and maintained...
March 28, 2024: Journal of Medical Internet Research
https://read.qxmd.com/read/38428194/the-mobile-x-ray-service-and-hip-fractures-the-impact-of-the-mobile-x-ray-service-on-the-hip-fast-track
#2
JOURNAL ARTICLE
S L Sundland, B Møller-Christensen
INTRODUCTION: Hip fracture is a serious affliction that requires fast care and an X-ray examination, which are provided by an ambulance and a visit to the radiology department, respectively. If a well-functioning mobile X-ray service could be developed, by examining the patient in their own home, both the work strain of hospital workers and patient suffering could be reduced. The purpose of this study was to determine if the mobile X-ray service could be a supplement to the fast-track process that is utilised by the ambulance service...
February 29, 2024: Radiography
https://read.qxmd.com/read/38238066/which-low-urgent-triaged-febrile-children-are-suitable-for-a-fast-track-an-observational-european-study
#3
JOURNAL ARTICLE
Chantal D Tan, Clementien L Vermont, Joany M Zachariasse, Ulrich von Both, Enitan D Carrol, Irini Eleftheriou, Marieke Emonts, Michiel van der Flier, Jethro Herberg, Benno Kohlmaier, Michael Levin, Emma Lim, Ian K Maconochie, Federico Martinon-Torres, Ruud G Nijman, Marko Pokorn, Irene Rivero-Calle, Aleksandra Rudzāte, Maria Tsolia, Werner Zenz, Dace Zavadska, Henriette A Moll
BACKGROUND: The number of paediatric patients visiting the ED with non-urgent problems is increasing, leading to poor patient flow and ED crowding. Fast track aims to improve the efficiency of evaluation and discharge of low acuity patients. We aimed to identify which febrile children are suitable for a fast track based on presenting symptoms and management. METHODS: This study is part of the Management and Outcome of Fever in children in Europe study, which is an observational study including routine data of febrile children <18 years attending 12 European EDs...
January 18, 2024: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/38129857/a-systematic-review-and-meta-analysis-of-short-stay-programmes-for-total-hip-and-knee-replacement-focusing-on-safety-and-optimal-patient-selection
#4
JOURNAL ARTICLE
Danielle Berkovic, Patrick Vallance, Ian A Harris, Justine M Naylor, Peter L Lewis, Richard de Steiger, Rachelle Buchbinder, Zanfina Ademi, Sze-Ee Soh, Ilana N Ackerman
BACKGROUND: Short-stay joint replacement programmes are used in many countries but there has been little scrutiny of safety outcomes in the literature. We aimed to systematically review evidence on the safety of short-stay programmes versus usual care for total hip (THR) and knee replacement (KR), and optimal patient selection. METHODS: A systematic review and meta-analysis. Randomised controlled trials (RCTs) and quasi-experimental studies including a comparator group reporting on 14 safety outcomes (hospital readmissions, reoperations, blood loss, emergency department visits, infection, mortality, neurovascular injury, other complications, periprosthetic fractures, postoperative falls, venous thromboembolism, wound complications, dislocation, stiffness) within 90 days postoperatively in adults ≥ 18 years undergoing primary THR or KR were included...
December 21, 2023: BMC Medicine
https://read.qxmd.com/read/38012289/fast-track-to-stroke-unit-for-patients-not-eligible-for-acute-intervention-a-case-control-register-study-on-1066-patients
#5
JOURNAL ARTICLE
Ingela Wennman, Helle Wijk, Katarina Jood, Eric Carlström, Bengt Fridlund, Linda Alsholm, Johan Herlitz, Per-Olof Hansson
Stroke patients not eligible for acute intervention often have low priority and may spend long time at the emergency department (ED) waiting for admission. The aim of this retrospective case-control register study was to evaluate outcomes for such "low priority" stroke patients who were transported via Fast Track directly to the stroke unit, according to pre-specified criteria by emergency medical service (EMS). The outcomes of Fast Track patients, transported directly to stroke unit (cases) were compared with the outcomes of patients who fulfilled these critera for Fast Track, but instead were transported to the ED (controls)...
November 27, 2023: Scientific Reports
https://read.qxmd.com/read/37801938/models-of-care-with-advanced-practice-nurses-in-the-emergency-department-a-scoping-review
#6
REVIEW
Samantha Horvath, Sanja Visekruna, Kelley Kilpatrick, Melissa McCallum, Nancy Carter
INTRODUCTION: Emergency departments play a critical role in healthcare systems internationally. Visits for emergency care continue to increase, related to poor access to primary care, the COVID-19 pandemic, and health human resource issues. International literature shows similar stressors in the emergency department. Extended wait times to see health providers lead to poor outcomes, and innovative models of care are needed to address emergency department overcrowding and to meet the needs of patients...
September 18, 2023: International Journal of Nursing Studies
https://read.qxmd.com/read/37788025/covid-lateral-damage-impact-of-the-post-covid-19-era-on-procedural-training-in-emergency-medicine-residency
#7
JOURNAL ARTICLE
Daniel Frank, Thomas Perera, Moshe Weizberg
Introduction: Hospitalizations during the coronavirus 2019 (COVID-19) pandemic peaked in New York in March-April 2020. In the months following, emergency department (ED) volumes declined. Our objective in this study was to examine the effect of this decline on the procedural experience of emergency medicine (EM) residents compared to the pre-pandemic period. Methods: We conducted this multicenter, retrospective cohort study of patients seen and key procedures performed by EM residents at hospitals spanning three Accreditation Committee for Graduate Medical Education-approved EM residencies in New York City and Nassau County, NY...
September 2023: Western Journal of Emergency Medicine
https://read.qxmd.com/read/37535398/tixagevimab-cilgavimab-for-preventing-covid-19-during-the-omicron-surge-retrospective-analysis-of-national-veterans-health-administration-electronic-data
#8
JOURNAL ARTICLE
Yinong Young-Xu, Lauren Epstein, Vincent C Marconi, Victoria Davey, Caroline Korves, Gabrielle Zwain, Jeremy Smith, Fran Cunningham, Robert A Bonomo, Adit A Ginde
Little is known regarding the effectiveness of tixagevimab/cilgavimab in preventing SARS-CoV-2 infection in vaccinated immunocompromised patients, particularly after the emergence of the Omicron variant. In this retrospective cohort study with exact matching and propensity score adjustment within the U.S. Department of Veterans Affairs (VA) healthcare system, we selected immunocompromised veterans age ≥18 years as of 1 January 2022, receiving VA healthcare. We compared a cohort of 1,878 patients treated with at least one dose of intramuscular tixagevimab/cilgavimab to 7,014 matched controls selected from patients who met study criteria but were not treated...
August 3, 2023: MBio
https://read.qxmd.com/read/37448487/automated-analysis-of-unstructured-clinical-assessments-improves-emergency-department-triage-performance-a-retrospective-deep-learning-analysis
#9
JOURNAL ARTICLE
Dana R Sax, E Margaret Warton, Oleg Sofrygin, Dustin G Mark, Dustin W Ballard, Mamata V Kene, David R Vinson, Mary E Reed
OBJECTIVES: Efficient and accurate emergency department (ED) triage is critical to prioritize the sickest patients and manage department flow. We explored the use of electronic health record data and advanced predictive analytics to improve triage performance. METHODS: Using a data set of over 5 million ED encounters of patients 18 years and older across 21 EDs from 2016 to 2020, we derived triage models using deep learning to predict 2 outcomes: hospitalization (primary outcome) and fast-track eligibility (exploratory outcome), defined as ED discharge with <2 resource types used (eg, laboratory or imaging studies) and no critical events (eg, resuscitative medications use or intensive care unit [ICU] admission)...
August 2023: Journal of the American College of Emergency Physicians open
https://read.qxmd.com/read/37372694/pain-self-management-with-inhaled-methoxyflurane-by-emergency-department-trauma-patients-a-prospective-interventional-single-center-study
#10
JOURNAL ARTICLE
Daniel Aiham Ghazali, Donia Bouzid, Alix Frachon, Sarah Ait-Abdesselam, Philippe Kenway, Christophe Choquet, Enrique Casalino
The coronavirus disease 2019 (COVID-19) pandemic has led to overcrowding in many emergency departments (EDs). The present single-center, prospective, interventional study (conducted at Bichat University Medical Center (Paris, France)) was designed to assess the impact of self-administered, inhaled, low-dose methoxyflurane on trauma pain in a pre-ED fast-track zone dedicated to the management of lower-acuity non-COVID-19 patients. In the first phase of the study, the control group consisted of patients with mild-to-moderate trauma pain, for whom the triage nurse initiated pain management (based on the World Health Organization (WHO)'s analgesic ladder)...
June 12, 2023: International Journal of Environmental Research and Public Health
https://read.qxmd.com/read/37189990/modern-paediatric-emergency-department-potential-improvements-in-light-of-new-evidence
#11
REVIEW
Roman Kula, Stanislav Popela, Jozef Klučka, Daniela Charwátová, Jana Djakow, Petr Štourač
The increasing attendance of paediatric emergency departments has become a serious health issue. To reduce an elevated burden of medical errors, inevitably caused by a high level of stress exerted on emergency physicians, we propose potential areas for improvement in regular paediatric emergency departments. In an effort to guarantee the demanded quality of care to all incoming patients, the workflow in paediatric emergency departments should be sufficiently optimised. The key component remains to implement one of the validated paediatric triage systems upon the patient's arrival at the emergency department and fast-tracking patients with a low level of risk according to the triage system...
April 17, 2023: Children
https://read.qxmd.com/read/36976590/operations-factors-associated-with-emergency-department-length-of-stay-analysis-of-a-national-operations-database
#12
JOURNAL ARTICLE
Maureen Canellas, Sean Michael, Kevin Kotkowski, Martin Reznek
INTRODUCTION: Prolonged emergency department (ED) length of stay (LOS) has been shown to adversely affect patient care. We sought to determine factors associated with ED LOS via analysis of a large, national, ED operations database. METHODS: We performed retrospective, multivariable, linear regression modeling using the 2019 Emergency Department Benchmarking Alliance survey results to identify associated factors of ED LOS for admitted and discharged patients. RESULTS: A total of 1,052 general and adult-only EDs responded to the survey...
January 31, 2023: Western Journal of Emergency Medicine
https://read.qxmd.com/read/36916344/-comparison-of-the-predictive-value-of-the-modified-cadillac-grace-and-timi-risk-scores-for-the-risk-of-short-term-death-in-patients-with-acute-st-segment-elevation-myocardial-infarction-after-percutaneous-coronary-intervention
#13
JOURNAL ARTICLE
Chunling Ji, Fang Song, Xiaomo Huang, Xiang Qu, Nan Qiu, Jiaying Zhu
OBJECTIVE: To establish a modified controlled abciximab and device investigation to lower late angioplasty complication (CADILLAC) score, and to compare the predictive value of modified CADILLAC score, the global registry of acute coronary event (GRACE) score and the thrombolysis in myocardial infarction (TIMI) score in predicting the risk of short-term death after percutaneous coronary intervention (PCI) in patients with acute ST segment elevation myocardial infarction (STEMI). METHODS: A retrospective study was conducted...
March 2023: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/36675793/non-typical-clinical-presentation-of-covid-19-patients-in-association-with-disease-severity-and-length-of-hospital-stay
#14
JOURNAL ARTICLE
Alexandros Skourtis, Konstantinos Ekmektzoglou, Theodoros Xanthos, Stella Stouraitou, Nicoletta Iacovidou
BACKGROUND: This study aimed to investigate the incidence of non-typical symptoms in ambulatory patients with mild-to-moderate COVID-19 infection and their potential association with disease progression. MATERIALS AND METHODS: Data on the symptomatology of COVID-19 patients presenting to the fast-track emergency department were collected between March 2020 and March 2021. Fever, cough, shortness of breath, and fatigue-weakness were defined as "typical" symptoms, whereas all other symptoms such as nasal congestion, rhinorrhea, gastrointestinal symptoms, etc...
January 10, 2023: Journal of Personalized Medicine
https://read.qxmd.com/read/36219937/fast-track-nonelective-laparoscopic-cholecystectomy-is-safe-and-feasible
#15
JOURNAL ARTICLE
Lucas Fair, John J Squiers, Kimberly Jacinto, Matthew Perryman, Jennifer Misenhimer, Somer Blair, Carlos Rodriguez
INTRODUCTION: Ample evidence exists to support the safety of fast-track discharge after elective laparoscopic cholecystectomy (LC), but there is currently no data available to support the safety of fast-tracking patients undergoing nonelective LC. We sought to determine whether fast-tracking patients undergoing nonelective LC is safe and feasible. METHODS: We performed a retrospective cohort review of 661 consecutive patients undergoing LC at a single teaching institution from April 2018 to January 2020...
October 8, 2022: Journal of Surgical Research
https://read.qxmd.com/read/36199491/management-of-adverse-events-in-early-clinical-trials-by-advanced-practice-providers-in-the-outpatient-setting-the-university-of-texas-md-anderson-cancer-center-experience
#16
JOURNAL ARTICLE
Fedricker D Barber, Erick Campbell, Yuko Yamamura, Clover J Patterson, Audrey C Hartnett, Holly Kinahan, Victoria A Miller, Amanda L Brink, Anna Poullard, Gabriele E Urschel, Andre Brantley, Isabel G Cepeda, Poonam Goswami, Sheena Charles, Shincy Philip, Sara Bresser, Sandra Musekiwa-Adjei, Nageli Perez, Hung Le, Penny Phillips, Vivek Subbiah, Funda Meric-Bernstam, Ecaterina E Dumbrava
Background: Advanced practice providers (APPs) play important roles in enrolling, educating, and caring for patients in clinical trials. However, much remains unknown about the role of APPs in managing adverse events (AEs) in early (phase I to II) clinical trials. In this study, we assessed the outpatient management of grade 3 to 4 AEs by APPs in early trials and characterized the workflow of our APP Phase I to II Fast Track (FT) Clinic. Patients and Methods: We retrospectively reviewed records of patients with advanced or metastatic solid tumors enrolled in phase I to II clinical trials who were seen by APPs from September 2017 to August 2018 in the APP phase I to II FT clinic in the Department of Investigational Cancer Therapeutics...
September 2022: Journal of the Advanced Practitioner in Oncology
https://read.qxmd.com/read/36075769/quality-improvement-implementing-nurse-standard-work-in-emergency-department-fast-track-area-to-reduce-patient-length-of-stay
#17
JOURNAL ARTICLE
Dorothy Williams, Lawrence D Fredendall, Gregory Hair, Jim Kilton, Cassie Mueller, Joshua D Gray, Christian Graver, Jaeyoung Kim
INTRODUCTION: The average length of stay of a fast-track area of a large urban hospital was excessively long, which affected the patient experience and the rate at which patients left without being seen. One approach to reducing average length of stay is to create nurse standard work. Nurse standard work was a defined set of process and procedures that reduce variability within a nurse's workflow. METHODS: Nurse standard work was created by a team of nurses assisted by management engineering using lean methodology and A3 problem solving...
September 5, 2022: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://read.qxmd.com/read/36056331/assessment-of-changes-in-gaze-patterns-during-training-in-point-of-care-ultrasound
#18
JOURNAL ARTICLE
Alice H Y Chan, Wei Feng Lee, Pascal W M Van Gerven, Jordan Chenkin
BACKGROUND: Point-of-care ultrasound (POCUS) is a core skill in emergency medicine (EM), however, there is a lack of objective competency measures. Eye-tracking technology is a potentially useful assessment tool, as gaze patterns can reliably discriminate between experts and novices across medical specialties. We aim to determine if gaze metrics change in an independent and predictable manner during ultrasound training. METHODS: A convenience sample of first-year residents from a single academic emergency department was recruited...
September 2, 2022: BMC Medical Education
https://read.qxmd.com/read/35914815/strengthening-emergency-care-systems-to-improve-patient-care-for-st-elevation-myocardial-infarction-stemi-at-a-high-volume-tertiary-care-centre-in-india
#19
JOURNAL ARTICLE
Bharath Gopinath, Akshay Kumar, Rajesh Sah, Sanjeev Bhoi, Nayer Jamshed, Meera Ekka, Praveen Aggarwal, Ashok Deorari, Balram Bhargava, Vignan Kappagantu
BACKGROUND: ST-elevation myocardial infarction (STEMI) is a highly time-sensitive and life-threatening condition. Early recognition and timely management are challenging in a busy emergency department (ED), especially in low/middle-income countries where emergency systems are often fragmented. The aim of our quality improvement (QI) project was to increase the percentage of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) with door to balloon (D2B) time of <90 min by 30% over 12 months...
August 2022: BMJ Open Quality
https://read.qxmd.com/read/35907271/investigating-racial-disparities-within-an-emergency-department-rapid-triage-system
#20
JOURNAL ARTICLE
Sean Boley, Abbey Sidebottom, Marc Vacquier, David Watson, Jeremy Olsen, Kelsey Echols, Sara Friedman
OBJECTIVES: Racial disparities in emergency medical care are abundant, and processes aimed to increase throughput, such as a rapid triage fast-track (FT) systems, may exacerbate these inequities. A FT strategy may be more susceptible to implicit bias as subjective information is obtained quickly. We aim to determine whether a FT model was associated with greater disparities between Black and White emergency department (ED) patients. METHODS: Triage-related outcomes were compared across race using a cohort selected from encounters in an ED that uses a FT model...
October 2022: American Journal of Emergency Medicine
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