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Emergency Department Boarding

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https://www.readbyqxmd.com/read/27913245/contextual-computing-a-bluetooth-based-approach-for-tracking-healthcare-providers-in-the-emergency-room
#1
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...
November 29, 2016: 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
#2
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
#3
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
#4
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
#5
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-computed-tomographic-measurement-that-can-predict-the-likelihood-of-surgical-management
#6
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...
October 14, 2016: 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
#7
Chin-Yen Han, Chun-Chih Lin, Suzanne Goopy, Ya-Chu Hsiao, Alan Barnard, Li-Hsiang Wang
AIMS: To understand the experiences and concerns of patients in the Emergency Department (ED) during inpatient boarding. BACKGROUND: Boarding in the ED is an increasingly common phenomenon worldwide. ED staff, patients, and their families become more stressed as the duration of boarding in the ED 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
#8
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
#9
Marvin S Swartz
No abstract text is available yet for this article.
November 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27791449/lean-intervention-improves-patient-discharge-times-improves-emergency-department-throughput-and-reduces-congestion
#10
Michael J Beck, Davin Okerblom, Anika Kumar, Subhankar Bandyopadhyay, Lisabeth V Scalzi
: (Abstract) Objective: To determine if a lean intervention improved emergency department (ED) throughput and reduced ED boarding by improving patient discharge efficiency from a tertiary care children's hospital. METHODS: The study was conducted at a tertiary care children's hospital to study the impact lean that changes made to an inpatient pediatric service line had on ED efficiency. Discharge times from the general pediatrics' service were compared to patients discharged from all other pediatric subspecialty services...
October 28, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27760245/implications-of-the-patient-protection-and-affordable-care-act-on-insurance-coverage-and-rehabilitation-use-among-young-adult-trauma-patients
#11
Cheryl K Zogg, Fernando Payró Chew, John W Scott, Lindsey L Wolf, Thomas C Tsai, Peter Najjar, Olubode A Olufajo, Eric B Schneider, Elliott R Haut, Adil H Haider, Joseph K Canner
Importance: Trauma is the leading cause of death and disability among young adults, who are also among the most likely to be uninsured. Efforts to increase insurance coverage, including passage of the Patient Protection and Affordable Care Act (ACA), were intended to improve access to care and promote improvements in outcomes. However, despite reported gains in coverage, the ACA's success in promoting use of high-quality care and enacting changes in clinical end points remains unclear...
October 19, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27759626/impact-of-performance-grading-on-annual-numbers-of-acute-myocardial-infarction-associated-emergency-department-visits-in-taiwan-results-of-segmented-regression-analysis
#12
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)
https://www.readbyqxmd.com/read/27751555/validation-and-comparison-of-imaging-based-scores-for-prediction-of-early-stroke-risk-after-transient-ischaemic-attack-a-pooled-analysis-of-individual-patient-data-from-cohort-studies
#13
Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27722805/role-of-computed-tomography-at-a-cancer-center-emergency-department
#14
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
https://www.readbyqxmd.com/read/27689922/yield-of-ct-pulmonary-angiography-in-the-emergency-department-when-providers-override-evidence-based-clinical-decision-support
#15
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
https://www.readbyqxmd.com/read/27681025/alignment-of-governance-and-senior-executive-perceptions-of-culture
#16
Evelyn Suk Yi Looi, Richard Greatbanks, André M Everett
Purpose The purpose of this paper is to examine the alignment of perceived organizational culture between Health Board chairs and Board members with that of their respective senior executive teams. It compares the degree of alignment between these two groups, and analyses them against District Health Board (DHB) performance using the New Zealand Ministry of Health's national measure "shorter stays in Emergency Departments." Design/methodology/approach Primary survey data were collected across eight DHBs using a modified version of the Organizational Culture Assessment Instrument and utilizes a sample of both higher and lower performing DHBs as defined by the "shorter stays" measure...
September 19, 2016: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/27670660/interpretations-of-diffusion-weighted-mr-imaging-by-radiology-residents-in-the-emergency-department-is-diagnostic-performance-influenced-by-the-level-of-residency-training
#17
Sungjae Lee, Hye Jin Baek, Hyun Kyung Jung, Jin Il Moon, Soo Buem Cho, Bo Hwa Choi, Kyungsoo Bae, Kyung Nyeo Jeon, Dae Seob Choi, Hwa Seon Shin, Dong Wook Kim
BACKGROUND: To evaluate the diagnostic performance of radiology residents' interpretations for diffusion-weighted MR imaging (DWI) in the emergency department at different levels of residency training. METHOD AND MATERIALS: A total of 160 patients who underwent DWI with acute neurologic symptoms were included in this retrospective study with an institutional review board approval. Four radiology residents with different training years and one attending neuroradiologist independently assessed the DWI results...
September 26, 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/27668922/system-stresses-in-2-pediatric-emergency-departments-and-2-pediatric-urgent-care-centers-during-the-2014-enterovirus-d68-outbreak
#18
Gregory P Conners, Stacy J Doyle, Milton A Fowler, Lisa L Schroeder, Thomas W Tryon
OBJECTIVE: To describe the association of an unprecedented large-scale Enterovirus-D68 outbreak in 2014 with changes in patient volume and acuity and system stress in 2 pediatric emergency departments and 2 pediatric urgent care centers of a single children's hospital. METHODS: We compared measures of patient volume, acuity, and system stress during the 2014 Enterovirus-D68 outbreak and the corresponding dates of the previous year. RESULTS: Both settings experienced large census increases during the Enterovirus-D68 outbreak; patient census increased significantly more in the pediatric urgent care setting (20...
September 23, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27668915/the-impact-of-mental-health-services-in-a-pediatric-emergency-department-the-implications-of-having-trained-psychiatric-professionals
#19
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
https://www.readbyqxmd.com/read/27641249/impact-of-prospective-verification-of-intravenous-antibiotics-in-an-ed
#20
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
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