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Emergency department overcrowding

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https://www.readbyqxmd.com/read/29137906/can-different-physicians-providing-urgent-and-non-urgent-treatment-improve-patient-flow-in-emergency-department
#1
Flora Fei-Fei Yau, Tsung-Cheng Tsai, Yan-Ren Lin, Kuan-Han Wu, Yuan-Jhen Syue, Chao-Jui Li
BACKGROUND: Emergency Department (ED) overcrowding is a worldwide problem, and it might be caused by prolonged patient stay in the ED. This study tried to analyze if different practice models influence patient flow in the ED. MATERIALS AND METHODS: A retrospective, 1-year cohort study was conducted across two EDs in the largest healthcare system in Taiwan. A total of 37,580 adult non-trauma patients were involved in the study. The clinical practice between two ED practice models was compared...
November 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29115072/emergency-department-visits-can-be-reduced-by-having-a-regular-doctor-for-adults-with-diabetes-mellitus-secondary-analysis-of-2013-korea-health-panel-data
#2
Clara Lee, Nak Jin Sung, Hyeong Seok Lim, Jae Ho Lee
Chronic diseases pose a major challenge to population health worldwide. Diabetes is a major chronic disease that is managed overwhelmingly in primary care. There is an increasing recognition of the role that primary care physicians play to achieve high-quality care for patients with diabetes. By analyzing 2013 Korean Health Panel data, the authors aimed to determine the current status of having a regular doctor (RD) for adults (aged 18 years or older) with diabetes. In addition, the association of having a RD with the experience of emergency department (ED) visits was determined in this study...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29110718/cardiac-patients-perceptions-of-neighboring-patients-risk-influence-on-psychological-stress-in-the-ed-and-subsequent-posttraumatic-stress
#3
Beatrice Konrad, David Hiti, Bernard P Chang, Jessica Retuerto, Jacob Julian, Donald Edmondson
BACKGROUND: As many as 12% of acute coronary syndrome (ACS) patients screen positive for post-traumatic stress disorder (PTSD) symptoms due to their cardiac event, and emergency department (ED) factors such as overcrowding have been associated with risk for PTSD. We tested the association of patients' perceptions of their proximity to a critically ill patient during ED evaluation for ACS with development of posttraumatic stress symptoms (PSS) in the month after hospital discharge. METHODS: Participants were enrolled in the REactions to Acute Care and Hospitalization (REACH) study during evaluation for ACS in an urban ED...
November 6, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29091157/analysis-of-the-internal-bed-regulation-committees-from-hospitals-of-a-southern-brazilian-city
#4
Vinícius Sabedot Soares
OBJECTIVE: To evaluate the composition of the Internal Regulation Committees created in hospitals of a capital city. METHODS: A cross-sectional descriptive study assessing the structure, processes and results of each Committee. RESULTS: The main reasons for implementing the committees were legal issues and overcrowding in the emergency department. The most monitored indicators were the occupancy rate and the mean length of stay, and the most observed results were reductions in the latter...
July 2017: Einstein
https://www.readbyqxmd.com/read/29076280/registered-nurses-perceptions-of-safe-care-in-overcrowded-emergency-departments
#5
Julia Eriksson, Linda Gellerstedt, Pernilla Hillerås, Åsa Gransjön Craftman
AIMS AND OBJECTIVE: To explore registered nurses' perceptions of safe practice in care for patients with an extended length of stay in the emergency department. BACKGROUND: Extended length of stay and overcrowding in emergency departments are described internationally as one of the most comprehensive challenges of modern emergency care. An emergency department is not designed, equipped or staffed to provide care for prolonged periods of time. This context, combined with a high workload, poses a risk to patient safety, with additional medical errors and an increased number of adverse events...
October 27, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29054572/chaotic-genetic-algorithm-and-adaboost-ensemble-metamodeling-approach-for-optimum-resource-planning-in-emergency-departments
#6
Milad Yousefi, Moslem Yousefi, Ricardo Poley Martins Ferreira, Joong Hoon Kim, Flavio S Fogliatto
Long length of stay and overcrowding in emergency departments (EDs) are two common problems in the healthcare industry. To decrease the average length of stay (ALOS) and tackle overcrowding, numerous resources, including the number of doctors, nurses and receptionists need to be adjusted, while a number of constraints are to be considered at the same time. In this study, an efficient method based on agent-based simulation, machine learning and the genetic algorithm (GA) is presented to determine optimum resource allocation in emergency departments...
October 17, 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29038668/overcrowding-and-its-association-with-patient-outcomes-in-a-median-low-volume-emergency-department
#7
J Laureano Phillips, Bradford E Jackson, Elizabeth L Fagan, Steven E Arze, Brenton Major, Nestor R Zenarosa, Hao Wang
BACKGROUND: Crowding occurs commonly in high volume emergency departments (ED) and has been associated with negative patient care outcomes. We aim to assess ED crowding in a median-low volume setting and evaluate associations with patient care outcomes. METHODS: This was a prospective single-center study from November 14, 2016 until December 14, 2016. ED crowding was measured every 2 h by three different estimation tools: National Emergency Department Overcrowding Score (NEDOCS); Community Emergency Department Overcrowding Score (CEDOCS); and Severely-overcrowding Overcrowding and Not-overcrowding Estimation Tool (SONET) categorized under six different levels of crowding (not busy, busy, extremely busy, overcrowded, severely overcrowded, and dangerously overcrowded)...
November 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29032791/deconstructing-the-4-h-rule-for-access-to-emergency-care-and-putting-patients-first
#8
Ian Scott, Clair Sullivan, Andrew Staib, Anthony Bell
Evidence suggests improved outcomes for patients requiring emergency admission to hospital are associated with improved emergency department (ED) efficiency and lower transit times. Factors preventing timely transfers of emergency patients to in-patient beds across the ED-in-patient interface are major causes for ED crowding, for which several remedial strategies are possible, including parallel processing of probable admissions, direct-to-ward admissions and single-point medical registrars for receiving and processing all referrals directed at specific speciality units...
October 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29029061/effects-of-access-to-radiology-in-out-of-hours-primary-care-in-the-netherlands-a-prospective-observational-study
#9
Martijn Hendrik Rutten, Marleen Smits, Yvonne Anthonia Sebastiana Peters, Willem Jan Jozef Assendelft, Gert Pieter Westert, Paul Hendrikus Josephus Giesen
Background: In the Netherlands, out-of-hours primary care is provided in general-practitioner-cooperatives (GPCs). These are increasingly located on site with emergency departments (ED), forming Emergency-Care-Access-Points (ECAP). A more efficient and economical organization of out-of-hours primary emergency care could be realized by increased collaboration at an ECAP. In this study, we compared the effects of different models with respect to access to (hospital) radiology by the GPC...
September 28, 2017: Family Practice
https://www.readbyqxmd.com/read/28992161/the-role-of-patient-perception-of-crowding-in-the-determination-of-real-time-patient-satisfaction-at-emergency-department
#10
Hao Wang, Jeffrey A Kline, Bradford E Jackson, Richard D Robinson, Matthew Sullivan, Marcus Holmes, Katherine A Watson, Chad D Cowden, Jessica Laureano Phillips, Chet D Schrader, JoAnna Leuck, Nestor R Zenarosa
Objective: To evaluate the associations between real-time overall patient satisfaction and Emergency Department (ED) crowding as determined by patient percepton and crowding estimation tool score in a high-volume ED. Design: A prospective observational study. Setting: A tertiary acute hospital ED and a Level 1 trauma center. Participants: ED patients. Intervention(s): Crowding status was measured by two crowding tools [National Emergency Department Overcrowding Scale (NEDOCS) and Severely overcrowded-Overcrowded-Not overcrowded Estimation Tool (SONET)] and patient perception of crowding surveys administered at discharge...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28970026/the-impact-of-the-improvement-in-internal-medicine-consultation-process-on-emergency-department-length-of-stay
#11
Sangheon Shin, Soo Hoon Lee, Dong Hoon Kim, Seong Chun Kim, Tae Yun Kim, Changwoo Kang, Jin Hee Jeong, Daesung Lim, Yong Joo Park, Sang Bong Lee
INTRODUCTION: Although consultations are essential for delivering safe, high-quality care to patients in emergency departments, they contribute to emergency department patient flow problems and overcrowding which is associated with several adverse outcomes, such as increases in patient mortality and poor quality care. This study aimed to investigate how time flow metrics including emergency department length of stay is influenced by changes to the internal medicine consultation policy...
September 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28924304/nedocs-vs-subjective-evaluation-%C3%A2-is-the-health-personnel-of-the-emergency-department-aware-of-its-overcrowding
#12
Mauricio Garcia-Romero, Claudia Geraldine Rita-Gáfaro, Jairo Quintero-Manzano, Anderson Bermon Angarita
INTRODUCTION: An emergency department (ED) is considered to be "overcrowded" when the number of patients exceeds its treatment capacity and it does not have the conditions to meet the needs of the next patient to be treated. This study evaluates overcrowding in the emergency department of a hospital in Colombia. OBJECTIVE: To compare the objective NEDOCS scale with a subjective evaluation by ED health staff in order to evaluate the differences between the two. METHODS: The NEDOCS scale was applied and a subjective overcrowding survey was administered to the medical staff and the charge nurse on duty 6 times per day (6:00 a...
June 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/28924282/overcrowding-and-possible-solutions-for-a-busy-paediatric-emergency-department
#13
Muhammad Irfan Habib, Khalid Mehmood Khan
OBJECTIVE: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions. METHODS: This retrospective study was conducted at the National Institute of Child Health, Karachi, and comprised data of all patients presenting to the emergency department from November 2014 to January 2015. Data was collected through the health management information system which generates daily report of patients. Patients who stayed at the emergency department for 4 or more hours were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28898330/-analysis-of-crowding-in-an-adult-emergency-department-of-a-tertiary-university-hospital
#14
Diego Hernán Giunta, Ana Soledad Pedretti, Cristina María Elizondo, María Florencia Grande Ratti, Fernán González Bernaldo de Quiros, Gabriel Darío Waisman, Hector José Peroni, Bernardo Martínez
BACKGROUND: Crowding in Emergency Departments (ED), results from the imbalance between the simultaneous demand for health care and the ability of the system to respond. The NEDOCS scale (National Emergency Department Crowding Scale) measures the degree of crowding in an ED. AIM: To describe ED Crowding characteristics, using the NEDOCS scale, in an Argentinean hospital. MATERIAL AND METHODS: A retrospective cohort study was conducted with all adult patient consultations between July 2013 and July 2014 at the ED of Hospital Italiano de Buenos Aires...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28870249/improving-emergency-department-radiology-transportation-time-a-successful-implementation-of-lean-methodology
#15
Eveline A Hitti, Ghada R El-Eid, Hani Tamim, Rana Saleh, Miriam Saliba, Lena Naffaa
BACKGROUND: Emergency Department overcrowding has become a global problem and a growing safety and quality concern. Radiology and laboratory turnaround time, ED boarding and increased ED visits are some of the factors that contribute to ED overcrowding. Lean methods have been used in the ED to address multiple flow challenges from improving door-to-doctor time to reducing length of stay. The objective of this study is to determine the effectiveness of using Lean management methods on improving Emergency Department transportation times for plain radiography...
September 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28855774/studying-the-variability-in-patient-inflow-and-staffing-trends-on-sundays-versus-other-days-in-the-academic-emergency-department
#16
K T Madavan Nambiar, Nisanth Menon Nedungalaparambil, Ottapura Prabhakaran Aslesh
BACKGROUND: Resource limitation, staff deficiency, and variability in patient inflow contribute to emergency department (ED) overcrowding, associated with delayed care, poor care, and poor patient outcomes. This study seeks to describe and analyze patient inflow variability and staffing trends on Sundays versus other days in a tertiary academic ED from South India. METHODS: Patient inflow and staffing data for 2 years were collected from hospital records, cross-checked, and statistically analyzed using Epi Info 7...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28834070/patient-navigation-for-patients-frequently-visiting-the-emergency-department-a-randomized-controlled-trial
#17
David Seaberg, Stanton Elseroad, Michael Dumas, Sudave Mendiratta, Jessica Whittle, Cheryl Hyatte, Jan Keys
BACKGROUND: Emergency department (ED) superutilizers (patients with five or more visits/year) comprise only 5% of the patients seen yet comprise 25% of total ED visits. Although the reasons for this are multifactorial, the cost to the patient and the community is exceedingly high. The cost is not just monetary; care of these patients is inappropriately fragmented and their presence in the ED may contribute to overcrowding affecting the community's emergency readiness. Previous studies using staff trained to help patients navigate their care options have had conflicting results...
August 21, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28741875/depression-and-anxiety-among-emergency-department-patients-utilization-and-barriers-to-care
#18
Beau Abar, Ashley Holub, Joseph Lee, Vincent DeRienzo, Flavia Nobay
BACKGROUND: Anxiety and depression rates among emergency department (ED) patients are substantially higher than those in the general population. Additionally, those with mental health issues often have difficulty accessing care. Unfortunately, issues of anxiety and depression are frequently not addressed in the ED due to competing care priorities. This may lead to increased burden and overcrowding in EDs. OBJECTIVE: This study related anxiety and depression with ED utilization and perceived barriers to care...
July 25, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28705743/the-influence-of-crowding-on-clinical-practice-in-the-emergency-department
#19
I-Min Chiu, Yan-Ren Lin, Yuan-Jhen Syue, Chia-Te Kung, Kuan-Han Wu, Chao-Jui Li
BACKGROUND: This study aimed to clarify the association between the crowding and clinical practice in the emergency department (ED). METHODS: This 1-year retrospective cohort study conducted in two EDs in Taiwan included 70,222 adult non-trauma visits during the day shift between July 1, 2011, and June 30, 2012. The ED occupancy status, determined by the number of patients staying during their time of visit, was used to measure crowding, grouped into four quartiles, and analyzed in reference to the clinical practice...
July 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28688771/optimal-measurement-interval-for-emergency-department-crowding-estimation-tools
#20
Hao Wang, Rohit P Ojha, Richard D Robinson, Bradford E Jackson, Sajid A Shaikh, Chad D Cowden, Rath Shyamanand, JoAnna Leuck, Chet D Schrader, Nestor R Zenarosa
STUDY OBJECTIVE: Emergency department (ED) crowding is a barrier to timely care. Several crowding estimation tools have been developed to facilitate early identification of and intervention for crowding. Nevertheless, the ideal frequency is unclear for measuring ED crowding by using these tools. Short intervals may be resource intensive, whereas long ones may not be suitable for early identification. Therefore, we aim to assess whether outcomes vary by measurement interval for 4 crowding estimation tools...
November 2017: Annals of Emergency Medicine
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