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ED Boarding

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December 2016: Journal of Homosexuality
I-Shiang Tzeng, Su-Hsun Liu, Kuan-Fu Chen, Chin-Chieh Wu, Jih-Chang Chen
To reduce patient boarding time at the emergency department (ED) and to improve the overall quality of the emergent care system in Taiwan, the Minister of Health and Welfare of Taiwan (MOHW) piloted the Grading Responsible Hospitals for Acute Care (GRHAC) audit program in 2007-2009.The aim of the study was to evaluate the impact of the GRHAC audit program on the identification and management of acute myocardial infarction (AMI)-associated ED visits by describing and comparing the incidence of AMI-associated ED visits before (2003-2007), during (2007-2009), and after (2009-2012) the initial audit program implementation...
October 2016: Medicine (Baltimore)
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No abstract text is available yet for this article.
October 2016: Journal of Community Health Nursing
Jessyca Couto Otoni, Julia Noschang, Thábata Yaedu Okamoto, Diego Rosseman Vieira, Michel Souto Mayor Petry, Lucas de Araujo Ramos, Paula Nicole Vieira Pinto Barbosa, Almir Galvão Vieira Bitencourt, Rubens Chojniak
To evaluate the imaging methods used at the emergency department (ED) of a cancer center, with emphasis on computed tomography (CT). A descriptive, retrospective, single-center study was conducted by reviewing imaging exams and medical records, after approval of the institution's Ethics Review Board. The demographic data, cancer history, and imaging exam requested were evaluated for all patients and the indications and results of head, chest, and abdominopelvic CT scans were also evaluated. During the study period, there were 8710 visits to the ED, and 5999 imaging studies were requested in 3788 patients (43...
October 8, 2016: Emergency Radiology
Zihao Yan, Ivan K Ip, Ali S Raja, Anurag Gupta, Joshua M Kosowsky, Ramin Khorasani
Purpose To determine the frequency of, and yield after, provider overrides of evidence-based clinical decision support (CDS) for ordering computed tomographic (CT) pulmonary angiography in the emergency department (ED). Materials and Methods This HIPAA-compliant, institutional review board-approved study was performed at a tertiary care, academic medical center ED with approximately 60 000 annual visits and included all patients who were suspected of having pulmonary embolism (PE) and who underwent CT pulmonary angiography between January 1, 2011, and August 31, 2013...
September 30, 2016: Radiology
Sharon M Holder, Kenneth Rogers, Eunice Peterson, Robbie Shoenleben, Dawn Blackhurst
OBJECTIVES: This study assessed improvement in the emergency department (ED) length of stay and costs after implementation of an ED program which added board-certified psychiatrists and trained psychiatric social workers to the pediatric ED. METHODS: A retrospective medical record and administrative data review were conducted for all pediatric psychiatric visits of children aged 5 to 18 years who were seen and discharged from the Greenville Memorial Hospital ED between January 1, 2007, and June 31, 2013...
September 23, 2016: Pediatric Emergency Care
Allyson Hunt, Steven Nakajima, Lisa Hall Zimmerman, Manav Patel
BACKGROUND: Delay in appropriate antibiotic therapy is associated with an increase in mortality and prolonged length of stay. Automatic dispensing machines decrease the delivery time of intravenous (IV) antibiotics to patients in the emergency department (ED). However, when IV antibiotics are not reviewed by pharmacists before being administered, patients are at risk for receiving inappropriate antibiotic therapy. The objective of this study was to determine if a difference exists in the time to administration of appropriate antibiotic therapy before and after implementation of prospective verification of antibiotics in the ED...
September 6, 2016: American Journal of Emergency Medicine
Samir A Haydar, Tania D Strout, Michael R Baumann
We read with interest the commentary by Dr. Hauswald(1) regarding our recently published article describing efforts to reduce ED length of stay through use of standardized holding orders by emergency physicians at the time of admission.(2) We agree that understanding the nuanced differences between the work of quality improvement (QI) and research is challenging in our roles as clinicians, administrators, researchers, educators, and QI specialists. Our institution is fortunate to have an Institutional Review Board (IRB) that is informed, accessible, and willing to help us make decisions that protect patients to the very best of our ability...
September 9, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Stacy L Reynolds, Jonathan R Studnek, Kathleen Bryant, Kelly VanderHave, Eric Grossman, Charity G Moore, James Young, Melanie Hogg, Michael S Runyon
INTRODUCTION: Fentanyl is the most widely studied intranasal (IN) analgesic in children. IN subdissociative (INSD) ketamine may offer a safe and efficacious alternative to IN fentanyl and may decrease overall opioid use during the emergency department (ED) stay. This study examines the feasibility of a larger, multicentre clinical trial comparing the safety and efficacy of INSD ketamine to IN fentanyl and the potential role for INSD ketamine in reducing total opioid medication usage. METHODS AND ANALYSIS: This double-blind, randomised controlled, pilot trial will compare INSD ketamine (1 mg/kg) to IN fentanyl (1...
2016: BMJ Open
Mark E Sharafinski, Elizabeth Sehnert, David Moe, Liyun Zhang, Pippa Simpson, Nghia J Vo
OBJECTIVES: The aim of the study was to determine whether embedding into the radiology report a patient-specific plan in the event of gastrojejunostomy (GJ) tube dysfunction reduces the need for after-hours utilization of pediatric interventional radiology resources for the replacement of GJ tubes. MATERIALS AND METHODS: This is a Health Insurance Portability and Accountability Act compliant, institutional review board-approved retrospective repeated cross-sectional study of patients requiring after-hours (5 PM-7 AM) or weekend (Saturday and Sunday) GJ tube replacement at a dedicated children's hospital, before and after the inclusion of a patient-specific plan in the radiology report as part of the electronic medical record...
September 2016: Journal of Pediatric Gastroenterology and Nutrition
Sarah A Sterling, Samantha R Seals, Alan E Jones, Melissa H King, Robert L Galli, Kristen C Isom, Richard L Summers, Kristi A Henderson
INTRODUCTION: Timely, appropriate intervention is key to improving outcomes in many emergent conditions. In rural areas, it is particularly challenging to assure quality, timely emergency care. The TelEmergency (TE) program, which utilizes a dual nurse practitioner and emergency medicine-trained, board-certified physician model, has the potential to improve access to quality emergency care in rural areas. The objective of this study was to examine how the implementation of the TE program impacts rural hospital Emergency Department (ED) operations...
July 28, 2016: Journal of Telemedicine and Telecare
Foster R Goss, Li Zhou, Scott G Weiner
BACKGROUND: Physician use of computerized speech recognition (SR) technology has risen in recent years due to its ease of use and efficiency at the point of care. However, error rates between 10 and 23% have been observed, raising concern about the number of errors being entered into the permanent medical record, their impact on quality of care and medical liability that may arise. Our aim was to determine the incidence and types of SR errors introduced by this technology in the emergency department (ED)...
September 2016: International Journal of Medical Informatics
Scott P Krall, Jose Guardiola, Peter B Richman
BACKGROUND: Emergency Department (ED) service evaluations are typically based on surveys of discharged patients. Physicians/administrators benefit from data that quantifies system-based factors that adversely impact the experience of those who represent the survey cohort. OBJECTIVE: While investigators have established that admitted patient boarding impacts overall ED throughput times, we sought to specifically quantify the relationship between throughput times for patients admitted (EDLOS) versus discharged home from the ED (DCLOS)...
September 2016: American Journal of Emergency Medicine
Caitlin E Loprinzi Brauer, Megan S Motosue, James T Li, John B Hagan, M Fernanda Bellolio, Sangil Lee, Ronna L Campbell
BACKGROUND: Anaphylaxis diagnostic criteria were proposed at the Second Symposium on the Definition and Management of Anaphylaxis. These criteria were 97% sensitive and 82% specific when retrospectively validated. OBJECTIVE: To prospectively evaluate the diagnostic accuracy of the National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network (NIAID/FAAN) criteria for diagnosis of anaphylaxis in the emergency department (ED). METHODS: We conducted a prospective observational study of patients seen in our institution's ED from April 2010 to March 2013...
July 9, 2016: Journal of Allergy and Clinical Immunology in Practice
Edoardo Pescatori, Giovanni Alei, Gabriele Antonini, Antonio Avolio, Carlo Bettocchi, Marco Bitelli, Francesco Boezio, Tommaso Cai, Enrico Caraceni, Maurizio Carrino, Fulvio Colombo, Enrico Conti, Antonio Corvasce, Federico Dehò, Stefano Fiordelise, Nicola Ghidini, Emilio Italiano, Giuseppe La Pera, Giovanni Liguori, Carlo Maretti, Nicola Mondaini, Alessandro Natali, Carlo Negro, Alessandro Palmieri, Fabrizio Palumbo, Matteo Paradiso, Massimo Polito, Diego Pozza, Mauro Silvani, Aldo Tamai, Massimiliano Timpano, Lilia Utizi, Francesco Varvello, Patrizio Vicini, Antonio Vitarelli, Giorgio Franco
OBJECTIVES: The Italian Society of Andrology, i.e. "Società Italiana di Andrologia" (S.I.A.), launched on December 2014 a prospective, multicenter, monitored and internal review board approved Registry for penile implants, the "INSIST-ED" (Italian Nationwide Systematic Inventarisation of Surgical Treatment for ED) Registry. Purpose of this first report is to present a baseline data analysis of the characteristics of penile implant surgery in Italy. MATERIAL AND METHODS: The INSIST-ED Registry is open to all surgeons implanting penile prostheses (all brands, all models) in Italy, providing anonymous patient, device, surgical procedure, outcome, follow-up data, for both first and revision surgeries...
2016: Archivio Italiano di Urologia, Andrologia
Joseph L Smith, Alessandro S De Nadai, Eric A Storch, Barbara Langland-Orban, Etienne Pracht, John Petrila
OBJECTIVE: Length of stay (LOS) and boarding in the emergency department (ED) for psychiatric patients have been the subject of concern, given the problems with crowding and excessive wait times in EDs. This investigation examined correlates of LOS and boarding in Florida EDs for patients presenting with psychiatric complaints from 2010 to 2013. METHODS: Utilizing the Florida ED discharge database, the authors examined the association of LOS and boarding with hospital and encounter factors for adult patients presenting with a primary psychiatric diagnosis (N=597,541)...
July 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Ed Finkel
No abstract text is available yet for this article.
April 10, 2016: Medical Economics
Farah Mustafa, Peadar Gilligan, Deborah Obu, Patrick O'Kelly, Eimear O'Hea, Catherine Lloyd, Sherif Kelada, Attracta Heffernan, Patricia Houlihan
OBJECTIVE: Many believe that hospital crowding manifesting in the ED with the boarding of admitted patients is a result of significant numbers of acute hospital beds being occupied by patients awaiting discharge to nursing homes, step-down facilities or home with or without additional support. This observational study was performed to establish the actual relationship between boarders in the ED and patients experiencing delayed discharge. METHODS: Data relating to the number of patients in the ED and their points in their patient pathway were entered into a logbook on a daily basis by the most senior doctor on duty...
September 2016: Emergency Medicine Journal: EMJ
K Lennquist Montán, L Riddez, S Lennquist, A C Olsberg, H Lindberg, D Gryth, P Örtenwall
AIM: The aim of this study was to use a simulation model developed for the scientific evaluation of methodology in disaster medicine to test surge capacity (SC) in a major hospital responding to a simulated major incident with a scenario copied from a real incident. METHODS: The tested hospital was illustrated on a system of magnetic boards, where available resources, staff, and patients treated in the hospital at the time of the test were illustrated. Casualties were illustrated with simulation cards supplying all data required to determine procedures for diagnosis and treatment, which all were connected to real consumption of time and resources...
June 22, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Ingrid Millet, Mustapha Sebbane, Nicolas Molinari, Emma Pages-Bouic, Fernanda Curros-Doyon, Bruno Riou, Patrice Taourel
OBJECTIVES: To assess the added-value of systematic unenhanced abdominal computed tomography (CT) on emergency department (ED) diagnosis and management accuracy compared to current practice, in elderly patients with non-traumatic acute abdominal symptoms. METHODS: Institutional review board approval and informed consent were obtained. This prospective study included 401 consecutive patients 75 years of age or older, admitted to the ED with acute abdominal symptoms, and investigated by early systematic unenhanced abdominal CT scan...
June 7, 2016: European Radiology
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