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Emergency department patient satisfaction

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https://www.readbyqxmd.com/read/28427444/interventions-to-reduce-wait-times-for-primary-care-appointments-a-systematic-review
#1
Dominique Ansell, James A G Crispo, Benjamin Simard, Lise M Bjerre
BACKGROUND: Accessibility and availability are important characteristics of efficient and effective primary healthcare systems. Currently, timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. When wait times for appointments are too long patients may experience worse health outcomes and are often left to use emergency department resources. The primary objective of our study was to systematically review the literature to identify interventions designed to reduce wait times for primary care appointments...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28426367/child-and-adolescent-emergency-and-urgent-mental-health-delivery-through-telepsychiatry-12-month-prospective-study
#2
Nasreen Roberts, Tina Hu, Nicholas Axas, Leanne Repetti
BACKGROUND: The significant gap between children and adolescents presenting for emergency mental healthcare and the shortage of child and adolescent psychiatrists constitutes a major barrier to timely access for psychiatric assessment for rural and remote areas. Unlike remote areas, urban emergency departments have in-house psychiatric consultation. Telepsychiatry may be a solution to ensure the same service for remote areas. However, there is a paucity of studies on the use of telepsychiatry for child and adolescent emergency consults...
April 20, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28402686/the-creation-and-implementation-of-an-outpatient-pulmonary-embolism-treatment-protocol
#3
Christopher Kabrhel, Rachel Rosovsky, Christopher Baugh, Blair Alden Parry, Erin Deadmon, Charlotte Kreger, Nicholas Giordano
The ability to rapidly and accurately risk-stratify patients with venous thromboembolism (VTE), and the availability of direct acting oral anticoagulants have reduced the need for intravenous anticoagulation for patients with deep vein thrombosis (DVT) and pulmonary embolism (PE). Emergency physicians are generally reluctant to discharge patients with VTE without defined and reliable follow up in place, and VTE patients treated with anticoagulants can be at risk for complications related to recurrent VTE and bleeding...
April 21, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28398973/effectiveness-of-nurse-initiated-interventions-on-patient-outcomes-in-the-emergency-department-a-systematic-review-protocol
#4
Luke Burgess, Kate Kynoch
The objective is to evaluate the effectiveness of nurse-initiated interventions (NIIs) on patient outcomes in the emergency department (ED).More specifically, the objectives are to identify the effectiveness of NIIs, including but not limited to, nurse-initiated medications, nurse-initiated intravenous fluid therapy and nurse-initiated pathology on patient waiting time, time to treatment, length of stay, pain levels, symptom relief, patient satisfaction, leave without being seen rates and mortality rates in ED settings...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28385299/kick-the-bucket-one-hospital-system-s-journey-to-reduce-clostridium-difficile
#5
Molly Bridget Delaney
PROBLEM: Albert Einstein defines insanity as doing the same thing over again but expecting different results. Although the United States claims to reduce antibiotic abuse, practice strict isolation, and clean meticulously, the burden of Clostridium difficile outpaces goals. Unless innovative approaches are tried, we risk culling elderly, immunosuppressed, and otherwise debilitated populations. Emergency departments are a primary access point for patients who are unable to wait for primary care...
April 3, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28382879/frequent-users-of-the-pediatric-emergency-department
#6
Jade Seguin, Esli Osmanlliu, Xun Zhang, Virginie Clavel, Harley Eisman, Robert Rodrigues, Maryam Oskoui
OBJECTIVES: Emergency department (ED) crowding is associated with increased morbidity and mortality. Its etiology is multifactorial, and frequent ED use (defined as more or equal to five visits per year) is a major contributor to high patient volumes. Our primary objective is to characterize the frequent user population. Our secondary objective is to examine risk factors for frequent emergency use. METHODS: We conducted a retrospective cohort study of pediatric emergency department (PED) visits at the Montreal Children's Hospital using the Système Informatique Urgence (SIURGE), electronic medical record database...
April 6, 2017: CJEM
https://www.readbyqxmd.com/read/28379370/reduction-in-blood-culture-contamination-through-use-of-initial-specimen-diversion-device
#7
Mark E Rupp, R Jennifer Cavalieri, Cole Marolf, Elizabeth Lyden
Background: Blood culture contamination is a clinically significant problem that results in patient harm and excess cost. Methods: In a prospective, controlled trial at an academic center Emergency Department, a device that diverts and sequesters the initial 1.5-2mL portion of blood (which presumably carries contaminating skin cells and microbes) was tested against standard phlebotomy procedures in patients requiring blood cultures due to clinical suspicion of serious infection...
April 3, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28378965/comparison-of-the-quality-of-night-paediatric-urgent-care-in-rural-and-urban-areas-of-lublin-province-eastern-poland-appraisals-by-parents-of-children-requiring-medical-attention
#8
Barbara Kołłątaj, Witold Kołłątaj, Katarzyna Wrzołek, Irena Dorota Karwat, Maria Klatka
 Introduction. The quality of primary medical care for children in Poland is unsatisfactory. In the ranking known as 'the European Health Consumer Index', Poland (taking the patient point of view on healthcare quality) is classified on the 27th position out of the 33 possible. The unsolved problems concern inter alia the quality and availability of night paediatric urgent care. OBJECTIVE: The aim was assessing the quality as well as the level of satisfaction with the night paediatric urgent care in the Lublin Province of eastern Poland...
March 31, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28376886/is-the-co-location-of-gps-in-primary-care-centres-associated-with-a-higher-patient-satisfaction-evidence-from-a-population-survey-in-italy
#9
Manila Bonciani, Sara Barsanti, Anna Maria Murante
BACKGROUND: Several countries have co-located General Practitioners (GPs) in Primary Care Centres (PCCs) with other health and social care professionals in order to improve integrated care. It is not clear whether the co-location of a multidisciplinary team actually facilitates a positive patient experience concerning GP care. The aim of this study was to verify whether the co-location of GPs in PCCs is associated positively with patient satisfaction with their GP when patients have experience of a multidisciplinary team...
April 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28375955/using-lean-management-to-reduce-emergency-department-length-of-stay-for-medicine-admissions
#10
Nazima Allaudeen, Anita Vashi, Julia S Breckenridge, Farnoosh Haji-Sheikhi, Sarah Wagner, Keith A Posley, Steven M Asch
BACKGROUND: The practice of boarding admitted patients in the emergency department (ED) carries negative operational, clinical, and patient satisfaction consequences. Lean tools have been used to improve ED workflow. Interventions focused on reducing ED length of stay (LOS) for admitted patients are less explored. OBJECTIVE: To evaluate a Lean-based initiative to reduce ED LOS for medicine admissions. DESIGN, SETTING, PATIENTS: Prospective quality improvement initiative performed at a single university-affiliated Department of Veterans Affairs (VA) medical center from February 2013 to February 2016...
April 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28371459/patient-satisfaction-with-procedural-sedation-in-the-emergency-department
#11
Olivia G Johnson, David McD Taylor, Marina Lee, Juen-Li Ding, Aadith Ashok, Damian Johnson, Daniel Peck, Jonathan Knott, Laurence Weinberg
OBJECTIVE: The aim of this study was to determine patient satisfaction with procedural sedation as a function of nature of the procedure and depth of sedation. METHOD: We undertook a prospective observational study of adult patients who received procedural sedation in two EDs (20 month period). The level of sedation was determined by an investigator, using the Observers Assessment of Anaesthesia/Sedation Scale (1 = awake to 6 = no response to noxious stimuli)...
March 29, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28366780/design-of-a-pragmatic-trial-in-minority-children-presenting-to-the-emergency-department-with-uncontrolled-asthma-the-chicago-plan
#12
Jerry A Krishnan, Molly A Martin, Cortland Lohff, Giselle S Mosnaim, Helen Margellos-Anast, Julie A DeLisa, Kate McMahon, Kim Erwin, Leslie S Zun, Michael L Berbaum, Michael McDermott, Nina E Bracken, Rajesh Kumar, S Margaret Paik, Sharmilee M Nyenhuis, Stacy Ignoffo, Valerie G Press, Zachary E Pittsenbarger, Trevonne M Thompson
Among children with asthma, black children are two to four times as likely to have an emergency department (ED) visit and die from asthma, respectively, compared to white children in the United States. Despite the availability of evidence-based asthma management guidelines, minority children are less likely than white children to receive or use effective options for asthma care. The CHICAGO Plan is a three-arm multi-center randomized pragmatic trial of children 5 to 11years old presenting to the ED with uncontrolled asthma that compares: [1] an ED-focused intervention to improve the quality of care on discharge to home, [2] the same ED-focused intervention together with a home-based community health worker (CHW)-led intervention, and [3] enhanced usual care...
March 31, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28363627/evaluation-of-a-nurse-initiated-acute-gastroenteritis-pathway-in-the-pediatric-emergency-department
#13
Rebecca A Carson, Shawna S Mudd, P Jamil Madati
Acute gastroenteritis (AGE) is a common illness treated in the emergency department. Delays in initiating rehydration for children with mild or moderate dehydration from AGE can lead to prolonged ED visits and increased resource utilization that do not provide prognostic value or support family-centered care. The purpose of this quality improvement project was to promote early oral rehydration therapy (ORT) for persons with AGE in an attempt to reduce unnecessary resource utilization and length of stay (LOS)...
March 28, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28363615/retrospective-comparison-of-the-low-risk-ankle-rules-and-the-ottawa-ankle-rules-in-a-pediatric-population
#14
Amy L Ellenbogen, Amy L Rice, Pranav Vyas
BACKGROUND: A recent multicenter prospective Canadian study presented prospective evidence supporting the Low Risk Ankle Rules (LRAR) as a means of reducing the number of ankle radiographs ordered for children presenting with an ankle injury while maintaining nearly 100% sensitivity. This is in contrast to a previous prospective study which showed that this rule yielded only 87% sensitivity. OBJECTIVE: It is important to further investigate the LRAR and compare them with the already validated Ottawa Ankle Rules (OAR) to potentially curb healthcare costs and decrease unnecessary radiation exposure without compromising diagnostic accuracy...
March 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28359707/evidence-based-practice-video-discharge-instructions-in-the-pediatric-emergency-department
#15
Elyssa B Wood, Gina Harrison, Amber Trickey, Mary Ann Friesen, Sarah Stinson, Erin Rovelli, Serena McReynolds, Kristina Presgrave
While a high quality discharge from a Pediatric Emergency Department helps caregivers feel informed and prepared to care for their sick child at home, poor adherence to discharge instructions leads to unnecessary return visits, negative health outcomes, and decreased patient satisfaction. Nurses at the Inova Loudoun Pediatric ED utilized the Johns Hopkins Model of Evidence Based Practice to answer the following question: Among caregivers who have children discharged from the ED, does the addition of video discharge instructions (VDI) to standard written/verbal discharge instructions (SDI) result in improved knowledge about the child's diagnosis, treatment, illness duration, and when to seek further medical care? METHODS: A multidisciplinary team reviewed available evidence and created VDI for three common pediatric diagnoses: gastroenteritis, bronchiolitis, and fever...
March 28, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28342622/an-analysis-of-the-relationship-between-burnout-socio-demographic-and-workplace-factors-and-job-satisfaction-among-emergency-department-health-professionals
#16
Menderes Tarcan, Neşet Hikmet, Benjamin Schooley, Mehmet Top, Gamze Yorgancıoglu Tarcan
INTRODUCTION: Burnout among emergency medical practitioners and personnel negatively affects career satisfaction and job performance and can lead to mental health issues, including anxiety, depression, and suicide. PURPOSE: This study investigated the relationship between the perceptions of burnout and job satisfaction of those working in two different hospital's emergency departments assessing the effect of burnout dimensions and additional factors (age, position, marital status, annual income, employment type, gender, patient encounters, and household economic well-being) on job satisfaction...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28334590/a-prospective-emergency-department-quality-improvement-project-to-improve-the-treatment-of-vaso-occlusive-crisis-in-sickle-cell-disease-lessons-learned
#17
Paula Tanabe, Caroline E Freiermuth, David M Cline, Susan Silva
BACKGROUND: Guidelines recommend rapid, aggressive management of vaso-occlusive crisis (VOC) for patients with sickle cell disease (SCD). A large prospective research and quality improvement (QI) project was conducted to measure changes in clinical outcomes in two EDs-academic medical centers with emergency medicine residency programs and Level 1 trauma centers-during a 2.5-year time period (October 2011-March 2014). METHODS: A QI team used a Plan-Do-Study-Act approach to modify and implement changes to opioid analgesic protocols for the emergency department (ED) treatment of VOC...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334466/home-care-services-for-sick-children-healthcare-professionals-conceptions-of-challenges-and-facilitators
#18
Charlotte Castor, Inger Hallström, Helena Hansson, Kajsa Landgren
AIMS AND OBJECTIVES: To explore healthcare professionals' conceptions of caring for sick children in home care services. BACKGROUND: Families often prefer home care to hospital care and the number of home care services for children is increasing. Caring for children at home has been recognised as challenging for healthcare professionals in home care services used to providing care predominately for adults. DESIGN: An inductive qualitative design...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28330452/a-structure-process-and-outcome-evaluation-of-the-geriatric-emergency-department-intervention-model-of-care-a-study-protocol
#19
Elizabeth Marsden, Andrea Taylor, Marianne Wallis, Alison Craswell, Marc Broadbent, Adrian Barnett, Kim-Huong Nguyen, Julia Crilly, Colleen Johnston, Amanda Glenwright
BACKGROUND: Emergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed...
March 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28325207/using-a-systematic-framework-of-interventions-to-improve-early-discharges
#20
Hemali Patel, Sasha Morduchowicz, Michelle Mourad
BACKGROUND: Late-afternoon hospital discharges can lead to admission bottlenecks and negatively affect the flow of patients needing hospital admission. Delays in discharge are a prevalent health care problem and have been linked to increased length of stay, lower patient satisfaction scores, and adverse outcomes. As a result, hospitals are placing a renewed emphasis on early discharge as a way to reduce admission delays and achieve optimal patient flow. This study shows that the Model for Improvement (MFI) is an effective approach for complex improvement efforts...
April 2017: Joint Commission Journal on Quality and Patient Safety
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