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Emergency room boarding

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https://www.readbyqxmd.com/read/29310983/applying-advanced-analytics-to-guide-emergency-department-operational-decisions-a-proof-of-concept-study-examining-the-effects-of-boarding
#1
R Andrew Taylor, Arjun Venkatesh, Vivek Parwani, Sharon Chekijian, Marc Shapiro, Andrew Oh, David Harriman, Asim Tarabar, Andrew Ulrich
BACKGROUND: Emergency Department (ED) leaders are increasingly confronted with large amounts of data with the potential to inform and guide operational decisions. Routine use of advanced analytic methods may provide additional insights. OBJECTIVES: To examine the practical application of available advanced analytic methods to guide operational decision making around patient boarding. METHODS: Retrospective analysis of the effect of boarding on ED operational metrics from a single site between 1/2015 and 1/2017...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#2
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the institutional review board. Study subjects were patients ≥ 18 years of age with an International Classification of Diseases code corresponding to a traumatic ICH and admitted to an ED observation unit (EDOU) of an urban, academic Level I trauma center between February 1, 2015, and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29121883/the-association-of-duration-of-boarding-in-the-emergency-room-and-the-outcome-of-patients-admitted-to-the-intensive-care-unit
#3
Saad Al-Qahtani, Abdullah Alsultan, Samir Haddad, Abdulmohsen Alsaawi, Moeed Alshehri, Sami Alsolamy, Afef Felebaman, Hani M Tamim, Nawfal Aljerian, Abdulaziz Al-Dawood, Yaseen Arabi
BACKGROUND: The demand for critical care beds is increasing out of proportion to bed availability. As a result, some critically ill patients are kept in the Emergency Department (ED boarding) awaiting bed availability. The aim of our study is to examine the impact of boarding in the ED on the outcome of patients admitted to the Intensive Care Unit(ICU). METHODS: This was a retrospective analysis of ICU data collected prospectively at King Abdulaziz Medical City, Riyadh from ED between January 2010 and December 2012 and all patients admitted during this time were evaluated for their duration of boarding...
November 9, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29051964/identification-of-quality-improvement-areas-in-pediatric-mri-from-analysis-of-patient-safety-reports
#4
Camilo Jaimes, Diana J Murcia, Karen Miguel, Cathryn DeFuria, Pallavi Sagar, Michael S Gee
BACKGROUND: Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. OBJECTIVE: To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. MATERIALS AND METHODS: In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015...
October 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29051881/fracture-management-in-pyknodysostosis-a-rare-case-report
#5
G Subramanya Gandhi, V Vijayanarasimhan, Lionel John, S Kailash, E Sathish Balaji
INTRODUCTION: Pyknodysostosis is congenital osteosclerotic skeletal dysplasia of a rare entity. It is an autosomal recessive disease which presents with short stature and generalized osteosclerosis of skeleton as result of decreased bone turnover. Here, the authors report a case of pyknodysostosis who presented to our emergency room with a pathological fracture in the shaft of the femur for which operative intervention was carried out. CASE REPORT: A 30-year-old female presented to our emergency room with a history of trivial injury to right thigh region and was diagnosed as fracture in her right femur shaft region...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28922307/safe-summers-adapting-evidence-based-injury-prevention-into-a-summer-curriculum
#6
Melody Schaeffer, Claire Cioni, Nicole Kozma, Catherine Rains, Greta Todd
BACKGROUND: Unintentional injury is the leading cause of death for those aged 0 years to 19 years. St. Louis Children's Hospital created Safety Land, a comprehensive injury prevention intervention which is provided during summer months. This program uses a life-size board game to teach safety education to children in ages 5 years to 11 years. The purpose of this study was to evaluate the effect of Safety Land on safety knowledge in children that participated in the intervention. METHODS: St...
November 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#7
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation after cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series. If there is a threshold below which survival was extremely unlikely, it might be useful in guiding decision-making in the early termination of futile resuscitative efforts...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28660786/cost-and-complications-of-percutaneous-fixation-of-hand-fractures-in-a-procedure-room-versus-the-operating-room
#8
Mark T Garon, Patrick Massey, Andreas Chen, Trevor Carroll, Bradley G Nelson, Anne M Hollister
BACKGROUND: The purpose of this study was to compare closed reduction and percutaneous pinning of metacarpal and phalanx fractures performed in the operating room (OR) versus the procedure room of the emergency department with primary outcomes being infection rate, radiographic union, and monetary cost. METHODS: From January 2006 to December 2010, all closed reduction and percutaneous pinnings of metacarpal and phalanx fractures (CPT codes: 26608; 26727) by a single board-certified hand surgeon (A...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28560549/cost-analysis-of-prostate-artery-embolization-pae-and-transurethral-resection-of-the-prostate-turp-in-the-treatment-of-benign-prostatic-hyperplasia
#9
Sandeep Bagla, John Smirniotopoulos, Julie Orlando, Rachel Piechowiak
PURPOSE: Prostatic arterial embolization (PAE) has emerged as a minimally invasive alternative to TURP; however, there are limited cost comparisons reported. The purpose of this study was to compare in-hospital direct costs of elective PAE and TURP in a hospital setting. MATERIALS AND METHODS: Institutional Review Board-approved retrospective review was performed on patients undergoing PAE and TURP from January to December 2014. Inclusion criteria included male patients greater than 40 years of age who presented for ambulatory TURP or PAE with no history of prior surgical intervention for BPH...
November 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28546781/role-of-adult-asthma-education-in-improving-asthma-control-and-reducing-emergency-room-utilization-and-hospital-admissions-in-an-inner-city-hospital
#10
Rashmi Mishra, Muhammad Kashif, Sindhaghatta Venkatram, Teresa George, Kristina Luo, Gilda Diaz-Fuentes
Objective. Asthma education programs have been shown to decrease healthcare utilization and improve disease control and management. The purpose of our study was to evaluate the impact of an outpatient adult asthma education program in an inner city hospital caring for patients with low socioeconomic and educational status. Methods. An asthma education program was implemented in September 2014. Patients who received education from September 2014 to July 2015 were evaluated. Outcomes were compared for the same group of patients before and after education...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28509853/predictors-of-caregiver-burden-among-mothers-of-children-with-chronic-conditions
#11
Karina Javalkar, Eniko Rak, Alexandra Phillips, Cara Haberman, Maria Ferris, Miranda Van Tilburg
OBJECTIVE: The complex medical regimens of children and adolescents with chronic conditions can have a significant impact on families and households. Caregivers may experience burden, which can lead to negative health consequences and poor quality of life. The objective of this study was to determine child-related predictors and risk factors for caregiver burden among parents of children with chronic conditions. METHODS: We distributed an institutional review board (IRB)-approved, online cross-sectional survey to parents of children who attended the Victory Junction therapeutic camp...
May 16, 2017: Children
https://www.readbyqxmd.com/read/28466184/thirty-day-emergency-room-visits-and-hospital-admissions-after-outpatient-non-vascular-image-guided-procedures
#12
Quang Nguyen, Sahil V Mehta, Jieming Fang, Robert Sheiman, Robert Kane, Muneeb Ahmed, Ammar Sarwar, Bettina Siewert, Olga R Brook
PURPOSE: To evaluate the rate of post-procedure emergency department (ED) visits and hospital admissions following outpatient non-vascular image-guided interventions performed under moderate sedation and to identify common and preventable causes of emergency department visits and hospital admissions. MATERIALS AND METHODS: Institutional review board approval was acquired for this HIPAA-compliant retrospective study with waiver of informed consent. 1426 consecutive patients undergoing 1512 outpatient image-guided procedures under moderate sedation from November 2012 to August 2014 were included...
October 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28432612/evaluation-of-the-analgesia-nociception-index-ani-in-healthy-awake-volunteers
#13
Rami Issa, Marco Julien, Elizabeth Décary, Olivier Verdonck, Louis-Philippe Fortier, Pierre Drolet, Philippe Richebé
BACKGROUND: Analgesia might be evaluated with simple changes in vital signs, a non-specific and non-sensitive method. Heart rate variability (HRV) correlates with autonomous nervous system activity and can be used to evaluate painful stimuli. Heart rate variability is then transformed into a numeric scale called the analgesia nociception index (ANI), where higher values represent predominant parasympathetic tone, thus low nociception. Under general anesthesia, the ANI decreases following painful stimuli and increases after administration of analgesia, but significant interindividual variability is present...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28431334/one-hundred-injured-patients-a-day-multicenter-emergency-room-surveillance-of-trauma-in-pakistan
#14
A A Hyder, S He, W Zafar, M U Mir, J A Razzak
OBJECTIVES: Injuries increasingly contribute to the global burden of disease in low- and middle-income countries. This study presents results from a large-scale surveillance study on injury from several urban emergency departments (EDs) in Pakistan. The objective is to document the burden of injuries that present to the healthcare system in Pakistan and to test the feasibility of an ED-based injury and trauma surveillance system. STUDY DESIGN: Cross-sectional study conducted using active surveillance approach...
July 2017: Public Health
https://www.readbyqxmd.com/read/28419343/utilizing-a-modified-care-coordination-measurement-tool-to-capture-value-for-a-pediatric-outpatient-parenteral-and-prolonged-oral-antibiotic-therapy-program
#15
Louise E Vaz, Cindi L Farnstrom, Kimberly K Felder, Judith Guzman-Cottrill, Hannah Rosenberg, Richard C Antonelli
Background.: Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component to successfully transition patients. Our objective was to assess outcomes of provider time spent on nonreimbursable CC activities in a pediatric OPAT program. Methods.: We used a qualitative feasibility pilot design and modified the Care Coordination Measurement Tool...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28289485/pneurip-tm-a-novel-respiratory-inductance-plethysmography-monitor
#16
Tariq Rahman, Ralph Page, Christopher Page, Jean-Remy Bonnefoy, Tim Cox, Thomas H Shaffer
Objective pulmonary function (PF) evaluation is essential for the diagnosis, monitoring, and management of many pediatric respiratory diseases as seen in the emergency room, intensive care, and outpatient settings. In this paper, the development and testing of a new noninvasive PF instrument, pneuRIP(TM), which utilizes respiratory inductance plethysmography (RIP) are discussed. The pneuRIP(TM) hardware includes a small circuit board that connects to the RIP bands and measures and wirelessly transmits the band inductance data to any designated wirelessly connected tablet...
March 2017: Journal of Medical Devices
https://www.readbyqxmd.com/read/28152810/interdisciplinary-care-rounds-in-the-community-changing-the-paradigm-of-supportive-service-involvement-in-cancer-care
#17
Hal E Crosswell, Terra Dillard, Jennifer Bayne, Tina Redenz, Kyle Duggan, Angela Belew
83 Background: Although cancer centers have focused on optimizing seamless Multidisciplinary Care (MDC) at tumor boards and/or clinics, there has been little published on effective ways to involve supportive services into the management of cancer patients. Historically, supportive services have been initiated when there is an active need rather than in anticipation of that need. As an alternative to pursuing such "crisis management" in our patients, Bon Secours St. Francis Cancer Center (BSSF) initiated Interdisciplinary Care (IDC) Rounds in an effort to anticipate patient needs, enhance quality of life (QoL), and potentially limit avoidable emergency room and hospital admissions...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28039649/or-fire-virtual-training-simulator-design-and-face-validity
#18
Denis Dorozhkin, Jaisa Olasky, Daniel B Jones, Steven D Schwaitzberg, Stephanie B Jones, Caroline G L Cao, Marcos Molina, Steven Henriques, Jinling Wang, Jeff Flinn, Suvranu De
BACKGROUND: The Virtual Electrosurgical Skill Trainer is a tool for training surgeons the safe operation of electrosurgery tools in both open and minimally invasive surgery. This training includes a dedicated team-training module that focuses on operating room (OR) fire prevention and response. The module was developed to allow trainees, practicing surgeons, anesthesiologist, and nurses to interact with a virtual OR environment, which includes anesthesia apparatus, electrosurgical equipment, a virtual patient, and a fire extinguisher...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27964809/a-feminist-framework-for-nurses-on-boards
#19
Lisa J Sundean, E Carol Polifroni
Nurses' knowledge, skills, and expertise uniquely situate them to contribute to health care transformation as equal partners in organizational board governance. The Institute of Medicine, the 10,000 Nurses on Boards Coalition, and a growing number of nurse and health care scholars advocate nurse board leadership; however, nurses are rarely appointed as voting board members. When no room is made for nurses to take a seat at the table, the opportunity is lost to harness the power of nursing knowledge for health care transformation and social justice...
November 2016: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/27913245/contextual-computing-a-bluetooth-based-approach-for-tracking-healthcare-providers-in-the-emergency-room
#20
Joshua Frisby, Vernon Smith, Stephen Traub, Vimla L Patel
Hospital Emergency Departments (EDs) frequently experience crowding. One of the factors that contributes to this crowding is the "door to doctor time", which is the time from a patient's registration to when the patient is first seen by a physician. This is also one of the Meaningful Use (MU) performance measures that emergency departments report to the Center for Medicare and Medicaid Services (CMS). Current documentation methods for this measure are inaccurate due to the imprecision in manual data collection...
January 2017: Journal of Biomedical Informatics
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