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ED Boarding

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https://www.readbyqxmd.com/read/29760941/hip-fracture-in-the-elderly-multidisciplinary-rehabilitation-femur-feasibility-study-testing-the-use-of-routinely-collected-data-for-future-health-economic-evaluations
#1
Nefyn H Williams, Kevin Mawdesley, Jessica L Roberts, Nafees Ud Din, Nicola Totton, Joanna M Charles, Zoe Hoare, Rhiannon T Edwards
Background: Health economic evaluations rely on the accurate measurement of health service resource use in order to calculate costs. These are usually measured with patient completed questionnaires using instruments such as the Client Service Receipt Inventory (CSRI). These rely on participants' recall and can be burdensome to complete. Health service activity data are routinely captured by electronic databases.The aim was to test methods for obtaining these data and compare with those data collected using the CSRI, within a feasibility study of an enhanced rehabilitation intervention following hip fracture (Fracture in the Elderly Multidisciplinary Rehabilitation: FEMuR)...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29760848/code-help-can-this-unique-state-regulatory-intervention-improve-emergency-department-crowding
#2
Sean S Michael, John P Broach, Kevin A Kotkowski, D Eric Brush, Gregory A Volturo, Martin A Reznek
Introduction: Emergency department (ED) crowding adversely affects multiple facets of high-quality care. The Commonwealth of Massachusetts mandates specific, hospital action plans to reduce ED boarding via a mechanism termed "Code Help." Because implementation appears inconsistent even when hospital conditions should have triggered its activation, we hypothesized that compliance with the Code Help policy would be associated with reduction in ED boarding time and total ED length of stay (LOS) for admitted patients, compared to patients seen when the Code Help policy was not followed...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29760842/appropriateness-of-extremity-magnetic-resonance-imaging-examinations-in-an-academic-emergency-department-observation-unit
#3
McKinley Glover, Ravi V Gottumukkala, Yadiel Sanchez, Brian J Yun, Theodore I Benzer, Benjamin A White, Anand M Prabhakar, Ali S Raja
Introduction: Emergency departments (ED) and hospitals face increasing challenges related to capacity, throughput, and stewardship of limited resources while maintaining high quality. Appropriate utilization of extremity magnetic resonance imaging (MRI) examinations within the emergency setting is not well known. Therefore, this study aimed to determine indications for and appropriateness of MRI of the extremities for musculoskeletal conditions in the ED observation unit (EDOU). Methods: We conducted this institutional review board-approved, retrospective study in a large, quaternary care academic center and Level I trauma center...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29752651/emergency-ct-for-assessment-and-management-of-blunt-traumatic-splenic-injuries-at-a-level-1-trauma-center-13-year-study
#4
Sergio Margari, Fernanda Garozzo Velloni, Massimo Tonolini, Ettore Colombo, Diana Artioli, Niccolò Ettore Allievi, Fabrizio Sammartano, Osvaldo Chiara, Angelo Vanzulli
PURPOSE: To determine the relationship between multidetector computed tomography (MDCT) findings, management strategies, and ultimate clinical outcomes in patients with splenic injuries secondary to blunt trauma. MATERIALS AND METHODS: This Institutional Review Board-approved study collected 351 consecutive patients admitted at the Emergency Department (ED) of a Level I Trauma Center with blunt splenic trauma between October 2002 and November 2015. Their MDCT studies were retrospectively and independently reviewed by two radiologists to grade splenic injuries according to the American Association for the Surgery of Trauma (AAST) organ injury scale (OIS) and to detect intraparenchymal (type A) or extraparenchymal (type B) active bleeding and/or contained vascular injuries (CVI)...
May 12, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29688158/prospective-comparison-of-the-diagnostic-accuracy-of-mr-imaging-versus-ct-for-acute-appendicitis
#5
Michael D Repplinger, Perry J Pickhardt, Jessica B Robbins, Douglas R Kitchin, Tim J Ziemlewicz, Scott J Hetzel, Sean K Golden, John B Harringa, Scott B Reeder
Purpose To compare the accuracy of magnetic resonance (MR) imaging with that of computed tomography (CT) for the diagnosis of acute appendicitis in emergency department (ED) patients. Materials and Methods This was an institutional review board-approved, prospective, observational study of ED patients at an academic medical center (February 2012 to August 2014). Eligible patients were nonpregnant and 12- year-old or older patients in whom a CT study had been ordered for evaluation for appendicitis. After informed consent was obtained, CT and MR imaging (with non-contrast material-enhanced, diffusion-weighted, and intravenous contrast-enhanced sequences) were performed in tandem, and the images were subsequently retrospectively interpreted in random order by three abdominal radiologists who were blinded to the patients' clinical outcomes...
April 24, 2018: Radiology
https://www.readbyqxmd.com/read/29683199/comparison-of-superb-microvascular-imaging-with-color-flow-and-power-doppler-imaging-of-small-hepatocellular-carcinomas
#6
Theodore J Dubinsky, Jonathan Revels, Sherry Wang, Giuseppe Toia, Rachelle Sonneborn, Daniel S Hippe, Todd Erpelding
OBJECTIVES: The purpose of this study was to compare Superb Microvascular Imaging (SMI; Toshiba America Medical Systems, Tustin, CA) with conventional color flow Doppler (CFD) and power Doppler (PD) imaging in the liver to distinguish between malignant and benign liver neoplasms. METHODS: After Institutional Review Board approval (number 449984-ED), patients undergoing routine pre-radiofrequency ablation planning ultrasound examinations for suspected hepatocellular carcinomas (HCCs) of less than 2 cm in diameter between January 1, 2015, and July 1, 2016, were prospectively identified...
April 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29665984/emergency-department-overcrowding-quality-improvement-in-a-taiwan-medical-center
#7
Chen-Mei Hsu, Li-Lin Liang, Yun-Te Chang, Wang-Chuan Juang
BACKGROUND/PURPOSE: Overcrowding of hospital emergency departments (ED) is a worldwide health problem. The Taiwan Joint Commission on Hospital Accreditation has stressed the importance of finding solutions to overcrowding, including, reducing the number of patients with >48 h stay in the ED. Moreover, the Ministry of Health and Welfare aims at transferring non-critical patients to district or regional hospitals. We report the results of our Quality Improvement Project (QIP) on ED overcrowding, especially focusing on reducing length of stay (LOS) in ED...
April 14, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29663580/emergency-physician-interpretation-of-point-of-care-ultrasound-for-identifying-and-grading-of-hydronephrosis-in-renal-colic-compared-with-consensus-interpretation-by-emergency-radiologists
#8
Sameer A Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G Andraous, Dharmesh Shukla, Mohammed Y Shariff, Magid M Makki, Tinsy T George, Saad S Khan, Stephen H Thomas, Peter A Cameron
OBJECTIVE: The ability of emergency physicians (EP) to identify hydronephrosis using point-of-care ultrasound (POCUS) has been assessed in the past using CT scans as the reference standard. We aimed to determine the ability of EP for identifying and grading of hydronephrosis on POCUS using the consensus interpretation of POCUS by emergency radiologists as the reference standard. METHODS: The study was conducted at an urban academic emergency department (ED) as a secondary analysis of previously collected ultrasound data from the EP performed POCUS-databank...
April 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29605480/emergency-department-boarding-and-adverse-hospitalization-outcomes-among-patients-admitted-to-a-general-medical-service
#9
Kito Lord, Vivek Parwani, Andrew Ulrich, Emily B Finn, Craig Rothenberg, Beth Emerson, Alana Rosenberg, Arjun K Venkatesh
OBJECTIVE: Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. METHOD: We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015...
March 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29602665/relocation-of-blood-gas-laboratory-to-the-emergency-department-helps-decrease-lactic-acid-values
#10
Jared Brazg, Phyllis Huang, Corey Weiner, Guneet Singh, Antonios Likourezos, Linda Salem, Eitan Dickman, John Marshall
IMPORTANCE: Emergency physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). OBJECTIVE: To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. METHODS: The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016...
March 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29581182/pediatric-hoverboard-and-skateboard-injuries
#11
Sean Bandzar, Daniel G Funsch, Rex Hermansen, Seema Gupta, Andrew Bandzar
OBJECTIVES: To investigate the characteristics of hoverboard injuries compared with skateboard injuries in children presenting to US emergency departments (EDs). METHODS: Data regarding hoverboard and skateboard injuries in children <18 years of age were obtained from the National Electronic Injury Surveillance System for calendar years 2015 and 2016. Data included demographics, body regions injured, and ED disposition. RESULTS: There were an estimated 26 854 hoverboard and 121 398 skateboard injuries treated in US EDs between 2015 and 2016...
March 26, 2018: Pediatrics
https://www.readbyqxmd.com/read/29575272/going-beyond-zip-code-can-a-person-s-address-help-us-improve-their-acute-care
#12
Erik J Blutinger, Zachary F Meisel, Eugenia C South
Do you know if the man you treated last night with unexplained chest pain lives on a block with a lot of boarded up houses or vacant lots? Does the woman with many repeat visits for asthma exacerbations live in an area with high rates of violent crime? Do these factors in any way relate to their ED visit - the complaint, the workup, the management, your discharge plan? If you knew more about your patient's immediate neighborhood surroundings, would that enhance your ability to deliver high quality acute care? During a busy shift, emergency care providers rarely have time to reflect on how individual and neighborhood socioeconomic factors impact their patient's health...
March 25, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29573904/causes-of-emergency-department-overcrowding-and-blockage-of-access-to-critical-services-in-beijing-a-2-year-study
#13
Zhen Wang, Xiaying Xiong, Shuang Wang, Junguo Yan, Martin Springer, R P Dellinger
BACKGROUND: Emergency department (ED) overcrowding is a serious issue worldwide. OBJECTIVES: This study was done to evaluate the degree of overcrowding in local "teaching hospitals" in Beijing, and to ascertain the apparent root causes for the pervasive degree of overcrowding in these EDs. METHODS: This is a multicenter cross-sectional study. The studied population included all ED patients from 18 metropolitan teaching hospital EDs in Beijing for calendar years 2013 and 2014...
March 21, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29570120/mortality-associated-with-emergency-department-boarding-exposure-are-there-differences-between-patients-admitted-to-icu-and-non-icu-settings
#14
Martin A Reznek, Benjavan Upatising, Samantha J Kennedy, Natassia T Durham, Richard M Forster, Sean S Michael
BACKGROUND: Emergency Department (ED) boarding threatens patient safety. It is unclear whether boarding differentially affects patients admitted to intensive care units (ICUs) versus non-ICU settings. RESEARCH DESIGN AND SUBJECTS: We performed a 2-hospital, 18-month, cross-sectional, observational, descriptive study of adult patients admitted from the ED. We used Kaplan-Meier estimation and Cox Proportional Hazards regression to describe differences in boarding time among patients who died during hospitalization versus those who survived, controlling for covariates that could affect mortality risk or boarding exposure, and separately evaluating patients admitted to ICUs versus non-ICU settings...
May 2018: Medical Care
https://www.readbyqxmd.com/read/29559357/relocation-of-blood-gas-laboratory-to-the-emergency-department-helps-decrease-lactic-acid-values
#15
Jared Brazg, Phyllis Huang, Corey Weiner, Guneet Singh, Antonios Likourezos, Linda Salem, Eitan Dickman, John Marshall
IMPORTANCE: Emergency Physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). OBJECTIVE: To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. METHODS: The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016...
March 12, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29525480/safety-of-reassessment-and-release-practice-for-mental-health-patients-boarded-in-the-emergency-department
#16
Sangil Lee, Karisa K Harland, Morgan Bobb Swanson, Sara Lawson, Elijah Dahlstrom, Lance Clemson, Elaine Himadi
OBJECTIVES: Among emergency department (ED) mental health and substance abuse (MHSA) patients, we sought to compare mortality and healthcare utilization by ED discharge disposition and inpatient bed request status. METHODS: A retrospective cohort study of 492 patients was conducted at a single University ED. We reviewed three groups of MHSA patients including ED patients that were admitted, ED patients with a bed request that were discharged from the ED, and ED patients with no bed request that were discharged from the ED...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29420772/purchased-behavioral-health-care-received-by-military-health-system-beneficiaries-in-civilian-medical-facilities-2000-2014
#17
Nikki R Wooten, Jordan A Brittingham, Ronald O Pitner, Abbas S Tavakoli, Diana D Jeffery, K Sue Haddock
Introduction: Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29413445/board-of-directors-ed-calendar
#18
(no author information available yet)
No abstract text is available yet for this article.
February 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29398586/prospective-study-of-enhanced-recovery-after-surgery-protocol-in-children-undergoing-reconstructive-operations
#19
K O Rove, M A Brockel, A F Saltzman, M I Dönmez, K E Brodie, D J Chalmers, B T Caldwell, V M Vemulakonda, D T Wilcox
BACKGROUND: Enhanced recovery after surgery (ERAS) protocol is a set of peri-operative strategies to increase speed of recovery. ERAS is well established in adults but has not been well studied in children. OBJECTIVE: The purpose of the current study was to establish the safety and efficacy of an ERAS protocol in pediatric urology patients undergoing reconstructive operations. It was hypothesized that ERAS would reduce length of stay and decrease complications when compared with historical controls...
February 1, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29394480/interprofessional-huddle-one-children%C3%A2-s-hospital%C3%A2-s-approach-to-improving-patient-flow
#20
Cheryl L McBeth, Blythe Durbin-Johnson, Elena O Siegel
Admitting pediatric patients promptly to the appropriate unit where they can receive specialty care is of critical importance to safe, quality care. A daily morning huddle was implemented at one children’s hospital as a quality improvement project. The aim of this project was to improve patient flow throughout the children’s hospital by improving interprofessional and interdepartmental communication and collaboration. This article reports on changes in patient flow before and after implementation of the daily huddle, as measured by pediatric emergency department (ED) boarding times...
March 2017: Pediatric Nursing
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