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Emergency Department Boarding

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https://www.readbyqxmd.com/read/28197843/copeptin-for-risk-stratification-in-non-traumatic-headache-in-the-emergency-setting-a-prospective-multicenter-observational-cohort-study
#1
Claudine Angela Blum, Bettina Winzeler, Nicole Nigro, Philipp Schuetz, Silke Biethahn, Timo Kahles, Cornelia Mueller, Katharina Timper, Katharina Haaf, Janina Tepperberg, Margareth Amort, Andreas Huber, Roland Bingisser, Peter Stephan Sándor, Krassen Nedeltchev, Beat Müller, Mira Katan, Mirjam Christ-Crain
BACKGROUND: In the emergency setting, non-traumatic headache is a benign symptom in 80% of cases, but serious underlying conditions need to be ruled out. Copeptin improves risk stratification in several acute diseases. Herein, we investigated the value of copeptin to discriminate between serious secondary headache and benign headache forms in the emergency setting. METHODS: Patients presenting with acute non-traumatic headache were prospectively enrolled into an observational cohort study...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28188202/progressive-prediction-of-hospitalisation-in-the-emergency-department-uncovering-hidden-patterns-to-improve-patient-flow
#2
Yuval Barak-Corren, Shlomo Hanan Israelit, Ben Y Reis
INTRODUCTION: One of the factors contributing to ED crowding is the lengthy delay in transferring an admitted patient from the ED to an inpatient department (ie, boarding time). An earlier start of the admission process using an automatic hospitalisation prediction model could potentially shorten these delays and reduce crowding. METHODS: Clinical, operational and demographic data were retrospectively collected on 80 880 visits to the ED of Rambam Health Care Campus in Haifa, Israel, from January 2011 to January 2012...
February 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28141672/conducting-community-health-needs-assessments-in-the-local-public-health-department-a-comparison-of-random-digit-dialing-and-the-community-assessment-for-public-health-emergency-response
#3
Kahler Stone, Allison Sierocki, Vaidehi Shah, Kelly R Ylitalo, Jennifer A Horney
CONTEXT: Community health needs assessments (CHNAs) are now required by the Affordable Care Act (ACA) for nonprofit hospitals and the Public Health Accreditation Board (PHAB) for local health departments that seek accreditation. Currently, various primary data collection methods exist that meet the ACA and PHAB requirements. OBJECTIVE: To compare 2 CHNA data collection methods implemented in the same geographical area from a local health department perspective. DESIGN AND SETTING: Two community surveys, one door-to-door and one telephone, in the 76706 zip code area of McLennan County, Texas...
January 30, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28125568/cluster-of-an-unusual-amnestic-syndrome-massachusetts-2012-2016
#4
Jed A Barash, Nick Somerville, Alfred DeMaria
In November 2015, a neurologist in the Boston, Massachusetts, area reported four cases of an uncommon amnestic syndrome involving acute and complete ischemia of both hippocampi, as identified by magnetic resonance imaging (MRI), to the Massachusetts Department of Public Health (MDPH) (1). A subsequent e-mail alert, generated by the Massachusetts Board of Registration in Medicine and sent to relevant medical specialists (including neurologists, neuroradiologists, and emergency physicians), resulted in the identification of 10 additional cases that had occurred during 2012-2016...
January 27, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28110985/a-profile-of-indian-health-service-emergency-departments
#5
Kenneth Bernard, Kohei Hasegawa, Ashley Sullivan, Carlos Camargo
STUDY OBJECTIVE: The Indian Health Service provides health care to eligible American Indians and Alaskan Natives. No published data exist on emergency services offered by this unique health care system. We seek to determine the characteristics and capabilities of Indian Health Service emergency departments (EDs). METHODS: All Indian Health Service EDs were surveyed about demographics and operational characteristics for 2014 with the National Emergency Department Inventory survey (available at http://www...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28063614/analysis-of-emergency-department-length-of-stay-for-mental-health-patients-at-ten-massachusetts-emergency-departments
#6
Mark D Pearlmutter, Kristin H Dwyer, Laura G Burke, Niels Rathlev, Louise Maranda, Greg Volturo
STUDY OBJECTIVE: Prolonged boarding times in the emergency department (ED) disproportionately affect mental health patients, resulting in patient and provider dissatisfaction and increased patient morbidity and mortality. Our objective is to quantify the burden of mental health boarding and to elucidate the effect of insurance together with demographic, social, and comorbid factors on length of stay. METHODS: We conducted a cross-sectional observational study of 871 consecutive patients requiring an ED mental health evaluation at one of 10 unaffiliated Massachusetts hospitals...
December 30, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28009394/eighty-years-of-cirm-a-journey-of-commitment-and-dedication-in-providing-maritime-medical-assistance
#7
Syed Sarosh Mahdi, Francesco Amenta
BACKGROUND: A review of activities of Centro Internazionale Radio Medico (International Radio Medical Centre, CIRM) from its foundation in 1935 until its 80th anniversary in 2015 was accomplished. CIRM was founded in 1935 to provide medical assistance via radio to ships with no doctor on board and other distant patients who cannot be reached by a doctor. In 1950 CIRM was established as a non-profit-making foundation and has benefited since 1957 from an annual contribution from the Italian government...
2016: International Maritime Health
https://www.readbyqxmd.com/read/27988200/dissecting-costs-of-ct-study-application-of-tdabc-time-driven-activity-based-costing-in-a-tertiary-academic-center
#8
Yoshimi Anzai, Marta E Heilbrun, Derek Haas, Luca Boi, Kirk Moshre, Satoshi Minoshima, Robert Kaplan, Vivian S Lee
RATIONALE AND OBJECTIVES: The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service...
December 14, 2016: Academic Radiology
https://www.readbyqxmd.com/read/27955985/quarterly-reporting-of-computed-tomography-ordering-history-reduces-the-use-of-imaging-in-an-emergency-department
#9
Richard Ehrlichman, Zachary Dezman, Joel Klein, Jean Jeudy, Daniel Lemkin
BACKGROUND: Computed tomography (CT) is a useful and necessary part of many emergency department (ED) assessments. However, the costs of imaging and the health risks associated with radiation exposure have sparked national efforts to reduce CT ordering in EDs. STUDY OBJECTIVE: We analyzed CT ordering habits prior to and following implementation of a feedback tool at a community hospital. METHODS: In this intervention study, we identified the CT-ordering habits of physicians and mid-level care providers (physician assistants and nurse practitioners) at baseline and after implementation of a system that sent quarterly feedback reports comparing their ordering habits with those of their peers...
December 9, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27925670/limited-abdominal-sonography-for-evaluation-of-children-with-right-lower-quadrant-pain
#10
Martha M Munden, Shannon Wai, Michael C DiStefano, Wei Zhang
OBJECTIVES: To determine whether a complete abdominal sonographic examination is necessary in the evaluation of children with right lower quadrant pain that is suspicious for appendicitis in the emergency department and whether performing a limited, more-focused study would miss clinically important disease. METHODS: With Institutional Review Board approval, a retrospective study was performed of 704 patients, from ages 5-19 years, presenting to the emergency department with right lower quadrant pain that was suspicious for appendicitis who underwent a complete abdominal sonographic examination...
January 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27922974/training-and-validating-a-deep-convolutional-neural-network-for-computer-aided-detection-and-classification-of-abnormalities-on-frontal-chest-radiographs
#11
Mark Cicero, Alexander Bilbily, Errol Colak, Tim Dowdell, Bruce Gray, Kuhan Perampaladas, Joseph Barfett
OBJECTIVES: Convolutional neural networks (CNNs) are a subtype of artificial neural network that have shown strong performance in computer vision tasks including image classification. To date, there has been limited application of CNNs to chest radiographs, the most frequently performed medical imaging study. We hypothesize CNNs can learn to classify frontal chest radiographs according to common findings from a sufficiently large data set. MATERIALS AND METHODS: Our institution's research ethics board approved a single-center retrospective review of 35,038 adult posterior-anterior chest radiographs and final reports performed between 2005 and 2015 (56% men, average age of 56, patient type: 24% inpatient, 39% outpatient, 37% emergency department) with a waiver for informed consent...
December 5, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27913245/contextual-computing-a-bluetooth-based-approach-for-tracking-healthcare-providers-in-the-emergency-room
#12
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
https://www.readbyqxmd.com/read/27878404/inter-rater-agreement-between-trained-emergency-medicine-residents-and-radiologists-in-the-examination-of-gallbladder-and-common-bile-duct-by-ultrasonography
#13
Javad Seyedhosseini, Azade Nasrelari, Narges Mohammadrezaei, Ehsan Karimialavijeh
STUDY OBJECTIVES: Bedside emergency ultrasonograAmerican Society of Emergency Radiologyphy is a rapid diagnostic tool in the emergency department (ED). Nevertheless, the learning curve for ultrasound (US) training in various indications has to date not been clearly defined. The aim of the present study was to assess how much a short specialized training program in hepatobiliary US might impact the skills of novice emergency medicine residents. METHODS: This was a prospective observational study conducted at a university-affiliated ED from May 2014 to January 2015...
November 22, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27866639/innovation-within-a-university-setting
#14
Elisabeth K Wynne, Thomas M Krummel
Elisabeth K. Wynne, MD, completed her undergraduate degree in bioengineering and is currently a surgical resident in training at the University of Washington. From 2014-2016, she served as a Biodesign Fellow at Stanford University. She plans to pursue a career of innovation as an academic surgeon. Thomas M. Krummel, MD, is the Emile Holman Professor and Chair Emeritus of the Department of Surgery at Stanford University School of Medicine. Throughout his career, Dr Krummel has been a pioneer and an innovator...
December 2016: Surgery
https://www.readbyqxmd.com/read/27864247/impact-of-a-pharmacist-delivered-discharge-and-follow-up-intervention-for-patients-with-acute-coronary-syndromes-in-qatar-a-study-protocol-for-a-randomised-controlled-trial
#15
Amani Zidan, Ahmed Awaisu, Nadir Kheir, Ziyad Mahfoud, Rasha Kaddoura, Sumaya AlYafei, Maguy Saffouh El Hajj
INTRODUCTION: Acute coronary syndrome (ACS) is one of the leading causes of morbidity and mortality worldwide. Secondary cardiovascular risk reduction therapy (consisting of an aspirin, a β-blocker, an ACE inhibitor or an angiotensin II receptor blocker and a statin) is needed for all patients with ACS. Less than 80% of patients with ACS in Qatar use this combination after discharge. This study is aimed to evaluate the effectiveness of clinical pharmacist-delivered intervention at discharge and tailored follow-up postdischarge on decreasing hospital readmissions, emergency department (ED) visits and mortality among patients with ACS...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27856021/interdisciplinary-development-of-an-improved-emergency-department-procedural-work-surface-through-iterative-design-and-use-testing-in-simulated-and-clinical-environments
#16
Xiao C Zhang, Ana M Bermudez, Pranav M Reddy, Ravi R Sarpatwari, Darin B Chheng, Taylor J Mezoian, Victoria R Schwartz, Quinneil J Simmons, Gregory D Jay, Leo Kobayashi
STUDY OBJECTIVE: A stable and readily accessible work surface for bedside medical procedures represents a valuable tool for acute care providers. In emergency department (ED) settings, the design and implementation of traditional Mayo stands and related surface devices often limit their availability, portability, and usability, which can lead to suboptimal clinical practice conditions that may affect the safe and effective performance of medical procedures and delivery of patient care...
November 14, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27823937/orbital-blowout-fractures-a-novel-ct-measurement-that-can-predict-the-likelihood-of-surgical-management
#17
Tamer N Mansour, Megan Rudolph, Derek Brown, Natalie Mansour, M Reza Taheri
OBJECTIVE: The purpose of this study is to identify an accurate and reliable computed tomographic (CT) measurement that can identify those patients presenting to the emergency department (ED) with orbital floor fracture (BOF) who require surgical repair to prevent ensuing visually debilitating diplopia and/or enophthalmos. METHODS: In this retrospective institutional review board-approved study, we reviewed 99 patients older than 18 years with orbital fractures treated in a level I trauma center from 2011 through 2015...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27805751/waiting-and-hoping-a-phenomenographic-study-of-the-experiences-of-boarded-patients-in-the-emergency-department
#18
Chin-Yen Han, Chun-Chih Lin, Suzanne Goopy, Ya-Chu Hsiao, Alan Barnard, Li-Hsiang Wang
AIMS AND OBJECTIVES: To understand the experiences and concerns of patients in the emergency department during inpatient boarding. BACKGROUND: Boarding in the emergency department is an increasingly common phenomenon worldwide. Emergency department staff, patients and their families become more stressed as the duration of boarding in the emergency department increases. Yet, there is limited knowledge of the experiences and concerns of boarded patients. DESIGN: The qualitative approach of phenomenography was used in the study...
November 2, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27804076/the-predictive-value-of-the-modified-early-warning-score-with-rapid-lactate-level-views-l-for-mortality-in-patients-of-age-65-or-older-visiting-the-emergency-department
#19
Hasan Basri Cetınkaya, Ozlem Koksal, Deniz Sigirli, Emrah Habip Leylek, Ozlem Karasu
The purpose of this study is to detect the predictive power of the modified early warning score with rapid lactate level (ViEWS-L) on mortality in critical patients over the age of 65 years admitted to the emergency department (ED). A total of 616 non-traumatic patients admitted to the Uludag University Faculty of Medicine ED who were 65 years of age or older were included in this study (Ethics board number: 2015-4/8). In this prospective study; the ViEWS-L score of the patients were calculated. The results have been evaluated with rate of mortality in the first 24 h starting from submission...
November 1, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27799026/emergency-department-boarding-nowhere-else-to-go
#20
Marvin S Swartz
No abstract text is available yet for this article.
November 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
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