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emergency department crowding

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https://www.readbyqxmd.com/read/28924304/nedocs-vs-subjective-evaluation-%C3%A2-is-the-health-personnel-of-the-emergency-department-aware-of-its-overcrowding
#1
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/28900665/-questionnaire-for-the-utilization-of-the-emergency-department-department-implications-for-the-patient-survey
#2
J Frick, M Möckel, M Schmiedhofer, J Searle, B Erdmann, M Erhart, A Slagman
BACKGROUND: For several years, Emergency Departments (ED) in Germany have observed increasing patient numbers, resulting in ED crowding. This leads to the question of whether patients with nonurgent conditions could also receive adequate treatment in primary care. Our objective was to develop a quantitative questionnaire to investigate in a larger patient group the reasons for this and to describe the implications for a patient survey in the ED. METHODS: The development of the questionnaire was based on a literature search and the results of the qualitative EPICS-2 study...
September 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28898330/-analysis-of-crowding-in-an-adult-emergency-department-of-a-tertiary-university-hospital
#3
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/28874952/duration-of-mechanical-ventilation-in-the-emergency-department
#4
Lauren B Angotti, Jeremy B Richards, Daniel F Fisher, Jeffrey D Sankoff, Todd A Seigel, Haitham S Al Ashry, Susan R Wilcox
INTRODUCTION: Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED) before intensive care unit (ICU) admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS). METHODS: This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28870193/mapping-infectious-disease-hospital-surge-threats-to-lessons-learnt-in-singapore-a-systems-analysis-and-development-of-a-framework-to-inform-how-to-decide-on-planning-and-response-strategies
#5
Shweta R Singh, Richard Coker, Hubertus J-M Vrijhoef, Yee Sin Leo, Angela Chow, Poh Lian Lim, Qinghui Tan, Mark I-Cheng Chen, Zoe Jane-Lara Hildon
BACKGROUND: Hospital usage and service demand during an Infectious Disease (ID) outbreak can tax the health system in different ways. Herein we conceptualize hospital surge elements, and lessons learnt from such events, to help build appropriately matched responses to future ID surge threats. METHODS: We used the Interpretive Descriptive qualitative approach. Interviews (n = 35) were conducted with governance and public health specialists; hospital based staff; and General Practitioners...
September 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28865753/developing-an-emergency-department-crowding-dashboard-a-design-science-approach
#6
Niels Martin, Jochen Bergs, Dorien Eerdekens, Benoît Depaire, Sandra Verelst
BACKGROUND: As an emergency department (ED) is a complex adaptive system, the analysis of continuously gathered data is valuable to gain insight in the real-time patient flow. To support the analysis and management of ED operations, relevant data should be provided in an intuitive way. AIM: Within this context, this paper outlines the development of a dashboard which provides real-time information regarding ED crowding. METHODS: The research project underlying this paper follows the principles of design science research, which involves the development and study of artifacts which aim to solve a generic problem...
August 30, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28844764/hospital-strategies-for-reducing-emergency-department-crowding-a-mixed-methods-study
#7
Anna Marie Chang, Deborah J Cohen, Amber Lin, James Augustine, Daniel A Handel, Eric Howell, Hyunjee Kim, Jesse M Pines, Jeremiah D Schuur, K John McConnell, Benjamin C Sun
STUDY OBJECTIVE: Emergency department (ED) crowding and patient boarding are associated with increased mortality and decreased patient satisfaction. This study uses a positive deviance methodology to identify strategies among high-performing, low-performing, and high-performance improving hospitals to reduce ED crowding. METHODS: In this mixed-methods comparative case study, we purposively selected and recruited hospitals that were within the top and bottom 5% of Centers for Medicare & Medicaid Services case-mix-adjusted ED length of stay and boarding times for admitted patients for 2012...
August 25, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28833779/patient-and-system-factors-related-to-missed-opportunities-for-screening-in-an-emr-driven-opt-out-hiv-screening-program-in-the-emergency-department
#8
Janet Lin, Sara Baghikar, Cammeo Mauntel-Medici, Sara Heinert, Daven Patel
OBJECTIVE: Emergency Departments (EDs) have implemented HIV screening using a variety of strategies. This study investigates how specific patient and health system factors in the ED impact who is and is not screened in a combined targeted and non-targeted, EMR-driven, opt-out, HIV screening program. METHODS: This was a retrospective, cross sectional study of ED visits where patients were determined eligible for HIV screening by an EMR algorithm between 11/18/2014 and 7/15/2015...
August 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28780916/assessing-and-improving-hospital-mass-casualty-preparedness-a-no-notice-exercise
#9
Daniel A Waxman, Edward W Chan, Francesca Pillemer, Timothy Wj Smith, Mahshid Abir, Christopher Nelson
In recent years, mass-casualty incidents (MCIs) have become more frequent and deadly, while emergency department (ED) crowding has grown steadily worse and widespread. The ability of hospitals to implement an effective mass-casualty surge plan, immediately and expertly, has therefore never been more important. Yet, mass-casualty exercises tend to be highly choreographed, pre-scheduled events that provide limited insight into hospitals' true capacity to respond to a no-notice event under real-world conditions...
August 7, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28714834/adjusting-patients-streaming-initiated-by-a-wait-time-threshold-in-emergency-department-for-minimizing-opportunity-cost
#10
Byungjoon B J Kim, Theodore R Delbridge, Dawn B Kendrick
Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28705743/the-influence-of-crowding-on-clinical-practice-in-the-emergency-department
#11
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/28693337/systems-opportunities-to-reduce-ed-crowding-from-nonemergency-referrals
#12
Carolyn Joy Sachs, Charles K Yu, Peter C Nauka, David L Schriger
Emergency department (ED) crowding threatens patient safety and is associated with increased mortality. This study explored the role of nonurgent referrals to the ED in crowding and collaborated on a large quality initiative with the study institution's accountable care organization (ACO) to provide timely alternatives to such referrals. Fifty-two percent of nonemergent ED patients report contacting a medical provider prior to coming to the ED, with 70% of those providers directing the patient to go to the ED...
March 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28688771/optimal-measurement-interval-for-emergency-department-crowding-estimation-tools
#13
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...
July 6, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28685049/setting-health-research-priorities-using-the-chnri-method-vii-a-review-of-the-first-50-applications-of-the-chnri-method
#14
Igor Rudan, Sachiyo Yoshida, Kit Yee Chan, Devi Sridhar, Kerri Wazny, Harish Nair, Aziz Sheikh, Mark Tomlinson, Joy E Lawn, Zulfiqar A Bhutta, Rajiv Bahl, Mickey Chopra, Harry Campbell, Shams El Arifeen, Robert E Black, Simon Cousens
BACKGROUND: Several recent reviews of the methods used to set research priorities have identified the CHNRI method (acronym derived from the "Child Health and Nutrition Research Initiative") as an approach that clearly became popular and widely used over the past decade. In this paper we review the first 50 examples of application of the CHNRI method, published between 2007 and 2016, and summarize the most important messages that emerged from those experiences. METHODS: We conducted a literature review to identify the first 50 examples of application of the CHNRI method in chronological order...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28659247/two-emergency-departments-6000km-apart-differences-in-patient-flow-and-staff-perceptions-about-crowding
#15
M Christien Van Der Linden, Munawar Khursheed, Khairunnissa Hooda, Jesse M Pines, Naomi Van Der Linden
INTRODUCTION: Emergency department (ED) crowding is a worldwide public health issue. In this study, patient flow and staff perceptions of crowding were assessed in Pakistan (Aga Khan University Hospital (AKUH)) and in the Netherlands (Haaglanden Medical Centre Westeinde (HMCW)). Bottlenecks affecting ED patient flow were identified. METHODS: First, a one-year review of patient visits was performed. Second, staff perceptions about ED crowding were collected using face-to-face interviews...
June 25, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28611876/effectiveness-of-resident-physicians-as-triage-liaison-providers-in-an-academic-emergency-department
#16
Victoria Weston, Sushil K Jain, Michael Gottlieb, Amer Aldeen, Stephanie Gravenor, Michael J Schmidt, Sanjeev Malik
INTRODUCTION: Emergency department (ED) crowding is associated with detrimental effects on ED quality of care. Triage liaison providers (TLP) have been used to mitigate the effects of crowding. Prior studies have evaluated attending physicians and advanced practice providers as TLPs, with limited data evaluating resident physicians as TLPs. This study compares operational performance outcomes between resident and attending physicians as TLPs. METHODS: This retrospective cohort study compared aggregate operational performance at an urban, academic ED during pre- and post-TLP periods...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28589691/medical-scribes-have-no-impact-on-the-patient-experience-of-an-emergency-department
#17
William Dunlop, Lachlan Hegarty, Margaret Staples, Michele Levinson, Michael Ben-Meir, Katherine Walker
OBJECTIVE: We aimed to evaluate patient perceptions of medical scribes in the ED and to test for scribe impacts on ED Net Promoter Scores, Press Ganey Surveys and other patient-centred topics. METHODS: Exploratory semi-structured interviews were conducted in the ED during wait times after scribed consultations. Interview results were used to derive topics relating to scribes. Items addressing these topics from validated surveys were combined with items from widely used patient satisfaction questionnaires...
June 6, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28583966/impact-of-ambulance-diversion-black-patients-with-acute-myocardial-infarction-had-higher-mortality-than-whites
#18
Renee Y Hsia, Nandita Sarkar, Yu-Chu Shen
This study investigated whether emergency department crowding affects blacks more than their white counterparts and the mechanisms behind which this might occur. Using a nonpublic database of patients in California with acute myocardial infarction between 2001 and 2011 and hospital-level data on ambulance diversion, we found that hospitals treating a high share of black patients with acute myocardial infarction were more likely to experience diversion and that black patients fared worse compared to white patients experiencing the same level of emergency department crowding as measured by ambulance diversion...
June 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28571105/visualising-emergency-department-capacity-in-an-emergency-department-capacity-clock-a-novel-tool-to-assess-and-communicate-overcrowding-and-access-block
#19
Ohad Dar, Jacques Loubser
Hospital-wide engagement is required to alleviate the problem of ED crowding and its associated adverse effects. To this end, the article describes a novel visualisation termed 'the ED Capacity Clock', which can be formatted using business intelligence software. This radial diagram represents ED capacity and its consumption in a format that can be understood intuitively and at a glance. The ED Capacity Clock is designed to promote common understanding and discussion between relevant hospital services and also acts as an auditing tool to monitor processes implemented to alleviate ED crowding...
June 1, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28535991/predictors-and-delays-associated-with-the-need-for-advanced-techniques-for-intravenous-access
#20
Michael D Witting, Siamak Moayedi, Latoya A Brown, Ammar Ismail
BACKGROUND: The need for advanced techniques for intravenous access (ATIVA) can lead to delays in care and contribute to emergency department (ED) crowding. OBJECTIVE: In this article, we estimate the delay and predictors associated with the need for ATIVA. METHODS: In this case-control study, we collected data from ED cases requiring ATIVA and control patients in whom i.v. access was gained by traditional inspection and palpation. We included two control groups-a random retrospective sample and a prospective limited convenience sample...
May 20, 2017: Journal of Emergency Medicine
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