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emergency department revisits

Derenda Lovelace, Diane Hancock, Sabrina S Hughes, Phyllis R Wyche, Claire Jenkins, Cindy Logan
BACKGROUND: In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%...
November 2016: Professional Case Management
A Brad Hall, April Novotny, Donna M Bhisitkul, James Melton, Tim Regan, Maureen Leckie
Introduction While pediatric asthma continues to be a highly studied disease, data to suggest clear strategies to decrease asthma related revisits or readmissions is lacking. The purpose of our study was to assess the effect of emergency department (ED) direct dispensing of beta-agonist metered dose inhalers on pediatric asthma ED revisit and readmission rates. Methods We conducted a retrospective cohort study of pediatric patients discharged from the pediatric ED with a diagnosis of asthma. Our primary outcome measured the rate of asthma revisits to the ED or admissions to the hospital within 28 days...
October 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Mathias C Blom, Karin Erwander, Lars Gustafsson, Mona Landin-Olsson, Fredrik Jonsson, Kjell Ivarsson
BACKGROUND: Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs. In short, primary triage means that a nurse separately evaluates patients who present in the Emergency Department (ED) and either refers them to primary care or discharges them home, if their complaints are perceived as being of low acuity. The aim of the present study is to elucidate whether high levels of in-hospital bed occupancy are associated with decreased permeability in primary triage...
September 22, 2016: BMC Emergency Medicine
Chun Nok Lam, Sanjay Arora, Michael Menchine
INTRODUCTION: Patients with mental health conditions frequently use emergency medical services. Many suffer from substance use and homelessness. If they use the emergency department (ED) as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already crowded healthcare system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community...
September 2016: Western Journal of Emergency Medicine
Brian R Sharp, Kristen M Sharp, Brian Patterson, Suzanne Dooley-Hash
INTRODUCTION: Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. METHODS: We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital...
September 2016: Western Journal of Emergency Medicine
Nesrin Al-Harthy, Kavita M Sudersanadas, Mohammed Al-Mutairi, Senthilvel Vasudevan, Ghada Bin Saleh, Malak Al-Mutairi, Lenna W Hussain
BACKGROUND: Discharge instructions are vital in postemergency patient care to help the caregiver understand the diagnosis and identify symptoms which require prompt readmission. In general, oral or written instructions are provided on discharge. However, there is a dearth of information on the efficacy of discharge instructions provided by physicians in KSA. OBJECTIVES: To evaluate the efficacy of discharge instructions for postpediatrics emergency visit. MATERIALS AND METHODS: This observational cross-sectional survey conducted in the Department of Paediatric Emergency at King Abdul Aziz Medical City, Riyadh, KSA, included 173 literate adult caregivers who had given their consent...
September 2016: Journal of Family & Community Medicine
Suzann Pershing, Douglas E Morrison, Tina Hernandez-Boussard
PURPOSE: To characterize population-based 30-day procedure-related readmissions (revisits) following cataract surgery. SETTING: Ambulatory cataract surgery performed in California, Florida, or New York DESIGN: Retrospective cohort study. METHODS: This study used all-capture state administrative datasets. Cataract procedures from CA, FL, and NY state ambulatory surgery settings were identified using ICD-9-CM and CPT codes. Thirty-day readmissions (revisits) were identified in inpatient, ambulatory, and emergency department settings across each state RESULTS: Across the three states, the all-cause 30-day readmission rate was 6...
September 8, 2016: American Journal of Ophthalmology
Brian W Patterson, Peter S Pang, Lora AlKhawam, Azita G Hamedani, Eneida A Mendonca, Ying-Qi Zhao, Arjun K Venkatesh
OBJECTIVE: The purpose of this article is to describe the association between initial CT for atraumatic headache and repeat emergency department (ED) visitation within 30 days of ED discharge. MATERIALS AND METHODS: A retrospective observational study was performed at an academic urban ED with more than 85,000 annual visits. All adult patients with a chief complaint of headache from January through December 2010 who were discharged after ED evaluation were included in the analysis...
August 30, 2016: AJR. American Journal of Roentgenology
Sarah Poole, Shaun Grannis, Nigam H Shah
High utilizers of emergency departments account for a disproportionate number of visits, often for nonemergency conditions. This study aims to identify these high users prospectively. Routinely recorded registration data from the Indiana Public Health Emergency Surveillance System was used to predict whether patients would revisit the Emergency Department within one month, three months, and six months of an index visit. Separate models were trained for each outcome period, and several predictive models were tested...
2016: AMIA Summits on Translational Science Proceedings
Glenn V Ostir, Stephen M Schenkel, Ivonne M Berges, Teresa Kostelec, Laura Pimentel
OBJECTIVE: The objective was to examine associations between cognitive health and unplanned emergency department (ED) revisits 30, 60, and 90 days after the initial visit. METHODS: Sociodemographic, clinical, and cognitive measures were collected on 110 white and African American adults, 65 years and older, who sought care in an inner-city ED. The information was collected via face-to-face interviews and review of the electronic medical record. Returns to the study-site ED 30, 60, and 90 days later were identified through a search of the electronic medical record...
October 2016: American Journal of Emergency Medicine
Jiraporn Sri-On, Adisak Nithimathachoke, Gregory Philip Tirrell, Sataporn Surawongwattana, Shan Woo Liu
Objective. Emergency department (ED) revisits are a common ED quality measure. This study was undertaken to ascertain the contributing factors of revisits within 48 hours to a Thai ED and to explore physician-related, illness-related, and patient-related factors behind those revisits. Methods. This study was a chart review from one tertiary care, urban Thai hospital from October 1, 2009, to September 31, 2010. We identified patients who returned to the ED within 48 hours for the same or related complaints after their initial discharge...
2016: Emergency Medicine International
Simone Natalie Vigod, Paul Kurdyak, Kinwah Fung, Andrea Gruneir, Nathan Herrmann, Neesha Hussain-Shamsy, Marly Isen, Elizabeth Lin, Paula Rochon, Valerie H Taylor, Dallas Seitz
OBJECTIVE: The objective of this study was to identify differences between men and women hospitalized for psychiatric conditions. METHODS: Men and women with an inpatient psychiatric hospitalization in Ontario, Canada, between 2008 and 2013 (N=95,055) were compared on sociodemographic characteristics, health history, and clinical profiles and on 30-day and 90-day postdischarge readmission, emergency department (ED) visits, self-harm, and death. RESULTS: Compared with men, women were older and more likely to be educated, to live with a partner, and to report trauma history...
August 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Heather L Short, Samir Sarda, Kurt F Heiss, Joshua J Chern, Mehul V Raval
Postprocedural revisits, readmissions, and reoperations are commonly tracked quality metrics and have reimbursement and hospital-level comparison implications. Our purpose was to document these rates after pediatric appendectomy and to identify patient factors related to these metrics. This study included 3756 appendectomies performed at a single institution from 2009 to 2013. Data were prospectively collected and clinical events within 30 days of discharge were analyzed. Regression models identified factors associated with each metric...
July 2016: American Surgeon
James Ryan, James Hendler, Kristin P Bennett
Electronic Healthcare Records (EHRs) have the potential to improve healthcare quality and to decrease costs by providing quality metrics, discovering actionable insights, and supporting decision-making to improve future outcomes. Within the United States Medicaid Program, rates of recidivism among emergency department (ED) patients serve as metrics of hospital performance that help ensure efficient and effective treatment within the ED. We analyze ED Medicaid patient data from 1,149,738 EHRs provided by a hospital over a 2-year period to understand the characteristics of the ED return visits within a 72-hour time frame...
December 2015: Big Data
Elizabeth Hohner, Melinda Ortmann, Umbreen Murtaza, Sheeva Chopra, Patricia A Ross, Meghan Swarthout, Leigh Efird, Emily Pherson, Mustapha Saheed
PURPOSE: The implementation of an emergency department (ED)-based clinical pharmacist transitions-of-care (TOC) program is described. SUMMARY: The intervention program consisted of collaboration between ED and ambulatory care pharmacists to provide patient-specific comprehensive medication review and education in the ED setting and to help ensure a coordinated transition to the ambulatory care setting by scheduling an ambulatory pharmacy clinic or home-based visit...
August 1, 2016: American Journal of Health-system Pharmacy: AJHP
Shawn J Rangel, Brett R Anderson, Rajendu Srivastava, Samir S Shah, Paul Ishimine, Mythili Srinivasan, Matthew Bryan, Wu Gong, Matt Hall, Russell Localio, Xianqun Luan, Seema Anandalwar, Ron Keren
OBJECTIVE: To compare treatment failure leading to hospital readmission in children with complicated appendicitis who received oral versus intravenous antibiotics after discharge. BACKGROUND: Antibiotics are often employed after discharge to prevent treatment failure in children with complicated appendicitis, although existing studies comparing intravenous and oral antibiotics for this purpose are limited. METHODS: We identified all patients aged 3 to 18 years undergoing appendectomy for complicated appendicitis, who received postdischarge antibiotics at 35 childrens hospitals from 2009 to 2012...
July 15, 2016: Annals of Surgery
Grant D Innes, Frank Scheuermeyer, Mike Law, Andrew McRae, Bryce Weber, Heidi Boyda, Kevin Lonergan, James Andruchow
BACKGROUND: Sex-related differences occur in many areas of medicine. ED studies have suggested differences in access to care, diagnostic imaging use, pain management, and intervention. We investigated sex-based differences in the care and outcomes for ED patients with acute renal colic. METHODS: This was a multi-center population-based retrospective observational cohort study using administrative data and supplemented by structured chart review. All patients seen in Calgary Health Region (CHR) emergency departments between January 1, 2014 and December 31, 2014 with an ED diagnosis of renal colic based on the following ICD-10 codes were eligible for inclusion: calculus of kidney (N200), calculus of ureter (N201), calculus of kidney with calculus of ureter (N202), hydronephrosis with renal and ureteral calculous obstruction (N132), unspecified renal colic (N23), and unspecified urinary calculus (N209)...
June 30, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
David F Penson
No abstract text is available yet for this article.
July 2016: Journal of Urology
Emily Spataro, Gregory H Branham, Dorina Kallogjeri, Jay F Piccirillo, Shaun C Desai
Importance: Estimates of the 30-day hospital revisit rate following septorhinoplasty and the risk factors associated with revisits are unknown in the current literature. Surgical 30-day readmission rates are important to establish, as they are increasingly used as a quality care metric and can incur future financial penalties from third-party payers and government agencies. Objective: To determine the rate of 30-day hospital revisits following septorhinoplasty and the risk factors associated with revisits...
June 16, 2016: JAMA Facial Plastic Surgery
Jane M Lavelle, Mercedes M Blackstone, Mary Kate Funari, Christine Roper, Patricia Lopez, Aileen Schast, April M Taylor, Catherine B Voorhis, Mira Henien, Kathy N Shaw
BACKGROUND AND OBJECTIVES: Urinary tract infection (UTI) screening in febrile young children can be painful and time consuming. We implemented a screening protocol for UTI in a high-volume pediatric emergency department (ED) to reduce urethral catheterization, limiting catheterization to children with positive screens from urine bag specimens. METHODS: This quality-improvement initiative was implemented using 3 Plan-Do-Study-Act cycles, beginning with a small test of the proposed change in 1 ED area...
July 2016: Pediatrics
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