keyword
MENU ▼
Read by QxMD icon Read
search

Emergency department throughput

keyword
https://www.readbyqxmd.com/read/29857424/patient-progression-a-hospital-wide-multi-disciplinary-data-driven-approach-to-moving-patients-safely-timely-efficiently
#1
Nancia T Odom, Mitch Babb, Laurie Velez, Zachary Cockerham
High emergency department length of stays (ED LOS), emergency department (ED) crowding and inefficient management of hospital patient throughput can negatively impact patient safety, patient care, and patient satisfaction [1]. In addition, patients who leave an ED without being seen by a medical provider can lead to potentially harmful outcomes. Duke Regional Hospital (DRH) set a strategic priority to improve hospital-wide patient progression. Our goals were to provide safe, efficient and timely movement of patients from admission to discharge...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29851913/how-long-does-it-take-to-diagnose-appendicitis-time-point-process-mapping-in-the-emergency-department
#2
Paulette I Abbas, Irving J Zamora, Simone C Elder, Mary L Brandt, Monica E Lopez, Robert C Orth, George S Bisset, Andrea T Cruz
OBJECTIVES: Appendicitis is the most common surgical emergency encountered in the pediatric emergency department (ED). We analyzed the time course of children evaluated for suspected appendicitis in relation to implementation of a risk-stratified ultrasound scoring system and structured reporting template (Appy-Score). METHODS: In July 2013, a 6-level ultrasound (US)-based appendicitis scoring system was developed and implemented. The records of children (age ≤18 years) who underwent limited abdominal US exams for suspected appendicitis at a large academic pediatric ED were reviewed retrospectively...
June 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29804715/comparing-the-effect-of-throughput-and-output-factors-on-emergency-department-crowding-a-retrospective-observational-cohort-study
#3
Malcolm B Doupe, Dan Chateau, Alecs Chochinov, Ellen Weber, Jennifer E Enns, Shelley Derksen, Joykrishna Sarkar, Michael Schull, Ricardo Lobato de Faria, Alan Katz, Ruth-Ann Soodeen
STUDY OBJECTIVE: This study compares how throughput and output factors affect emergency department (ED) median waiting room time. METHODS: Administrative health care use records were used to identify all daytime (8 am to 8 pm) visits made to adult EDs in Winnipeg, Canada, between April 1, 2012, and March 31, 2013. First, we measured the waiting room time (from patient registration until transfer into the ED) of each index visit (incoming patient). We then linked each index visit to a group of existing patients surrounding it and counted the number of existing patients engaged in throughput processes (radiographs, computed tomography [CT] scans, advanced diagnostic tests) and one output process (waiting to be hospitalized)...
May 24, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29760847/decreased-nursing-staffing-adversely-affects-emergency-department-throughput-metrics
#4
Zachariah Ramsey, Joseph S Palter, John Hardwick, Jordan Moskoff, Errick L Christian, John Bailitz
Introduction: The effect of nurse staffing on emergency department (ED) efficiency remains a significant area of interest to administrators, physicians, and nurses. We believe that decreased nursing staffing adversely affects key ED throughput metrics. Methods: We conducted a retrospective observational review of our electronic medical record database from 1/1/2015 to 12/31/2015 at a high-volume, urban public hospital. We report nursing hours, door-to-discharge length of stay (LOS) and door-to-admit LOS, and percentage of patients who left without being seen (LWBS)...
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
#5
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/29716799/emergency-and-critical-care-applications-for-contrast-enhanced-ultrasound
#6
REVIEW
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
April 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29706114/service-delivery-innovation-for-hospital-emergency-management-using-rich-organizational-modelling
#7
Yogit Dhakal, Moshiur Bhuiyan, Pwc Prasad, Aneesh Krishna
The purpose of this article is to identify and assess service delivery issues within a hospital emergency department and propose an improved model to address them. Possible solutions and options to these issues are explored to determine the one that best fits the context. In this article, we have analysed the emergency department's organizational models through i* strategic dependency and rational modelling technique before proposing updated models that could potentially drive business process efficiencies...
April 1, 2018: Health Informatics Journal
https://www.readbyqxmd.com/read/29674366/can-interprofessional-teamwork-reduce-patient-throughput-times-a-longitudinal-single-centre-study-of-three-different-triage-processes-at-a-swedish-emergency-department
#8
Jenny Liu, Italo Masiello, Sari Ponzer, Nasim Farrokhnia
OBJECTIVE: To determine the impact on emergency department (ED) throughput times and proportion of patients who leave without being seen by a physician (LWBS) of two triage interventions, where comprehensive nurse-led triage was first replaced by senior physician-led triage and then by interprofessional teamwork. DESIGN: Single-centre before-and-after study. SETTING: Adult ED of a Swedish urban hospital. PARTICIPANTS: Patients arriving on weekdays 08:00 to 21:00 during three 1-year periods in the interval May 2012 to November 2015...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29661381/a-review-of-the-safety-and-efficacy-of-inhaled-methoxyflurane-as-an-analgesic-for-outpatient-procedures
#9
REVIEW
C Jephcott, J Grummet, N Nguyen, O Spruyt
Methoxyflurane delivered via a hand-held inhaler is a proven analgesic which has been used in Australasia for emergency relief of trauma associated pain since the 1970s. The agent is self-administered by the patient under the supervision of trained personnel. More than 5 million patients have received inhaled methoxyflurane without significant side effects. Methoxyflurane is also licensed in Australasia for the relief of pain in monitored conscious patients requiring analgesia for minor surgical procedures...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29581808/standardized-reporting-system-use-during-handoffs-reduces-patient-length-of-stay-in-the-emergency-department
#10
Robert T Dahlquist, Karina Reyner, Richard D Robinson, Ali Farzad, Jessica Laureano-Phillips, John S Garrett, Joseph M Young, Nestor R Zenarosa, Hao Wang
Background: Emergency department (ED) shift handoffs are potential sources of delay in care. We aimed to determine the impact that using standardized reporting tool and process may have on throughput metrics for patients undergoing a transition of care at shift change. Methods: We performed a prospective, pre- and post-intervention quality improvement study from September 1 to November 30, 2015. A handoff procedure intervention, including a mandatory workshop and personnel training on a standard reporting system template, was implemented...
May 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29560068/evaluation-of-a-novel-handoff-communication-strategy-for-patients-admitted-from-the-emergency-department
#11
Christopher J Smith, Russell J Buzalko, Nathan Anderson, Joel Michalski, Jordan Warchol, Stephen Ducey, Chad E Branecki
Introduction: Miscommunication during inter-unit handoffs between emergency and internal medicine physicians may jeopardize patient safety. Our goal was to evaluate the impact of a structured communication strategy on the quality of admission handoffs. Methods: We conducted a mixed-methods, pre-test/post-test study at a 560-bed academic health center with 60,000 emergency department (ED) patient visits per year. Admission-handoff best practices were integrated into a modified SBAR format, resulting in the Situation, Background, Assessment, Responsibilities & Risk, Discussion & Disposition, Read-back & Record (SBAR-DR) model...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29534785/impact-of-physician-payment-mechanism-on-emergency-department-operational-performance
#12
Grant D Innes, Frank X Scheuermeyer, Julian Marsden, Chad Kim Sing, Dan Kalla, Rob Stenstrom, Michael Law, Eric Grafstein
CLINICIAN'S CAPSULE What is known about the topic? Fee-for-service compensation may motivate physicians to see more patients and improve throughput, or drive excessive testing and referral behaviour that undermine emergency performance. What did this study ask? Does fee-for-service payment reduce emergency wait times, length of stay, and left without being seen rates? What did this study find? We observed an unsustained 24% reduction in time to physician, but no change in length of stay or left without being seen rates...
March 2018: CJEM
https://www.readbyqxmd.com/read/29447352/improvement-of-emergency-department-patient-flow-using-lean-thinking
#13
Miquel Sánchez, Montse Suárez, María Asenjo, Ernest Bragulat
Objective: To apply lean thinking in triage acuity level-3 patients in order to improve emergency department (ED) throughtput and waiting time. Design: A prospective interventional study. Setting: An ED of a tertiary care hospital. Participants: Triage acuity level-3 patients. Intervention(s): To apply lean techniques such as value stream mapping, workplace organization, reduction of wastes and standardization by the frontline staff...
May 1, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29384780/effect-of-emergency-department-and-icu-occupancy-on-admission-decisions-and-outcomes-for-critically-ill-patients
#14
Kusum S Mathews, Matthew S Durst, Carmen Vargas-Torres, Ashley D Olson, Madhu Mazumdar, Lynne D Richardson
OBJECTIVES: ICU admission delays can negatively affect patient outcomes, but emergency department volume and boarding times may also affect these decisions and associated patient outcomes. We sought to investigate the effect of emergency department and ICU capacity strain on ICU admission decisions and to examine the effect of emergency department boarding time of critically ill patients on in-hospital mortality. DESIGN: A retrospective cohort study. SETTING: Single academic tertiary care hospital...
May 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29383053/taking-advantage-of-the-teachable-moment-a-review-of-learner-centered-clinical-teaching-models
#15
REVIEW
Sneha A Chinai, Todd Guth, Elise Lovell, Michael Epter
When working in a chaotic Emergency Department (ED) with competing priorities, clinical teaching may be sacrificed for the sake of patient flow and throughput. An organized, efficient approach to clinical teaching helps focus teaching on what the learner needs at that moment, incorporates regular feedback, keeps the department on track, and prevents over-teaching. Effective clinical teaching in a busy environment is an important skill for senior residents and faculty to develop. This review will provide a critique and comparison of seven structured teaching models to better prepare readers to seize the teachable moment...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29380730/hurry-up-it-s-quiet-in-the-emergency-department
#16
E Ter Avest, B T Onnes, T van der Vaart, M J Land
INTRODUCTION: Emergency department (ED) crowding is a contemporary problem. Solutions are multiple, but often involve a lengthy implementation process and/or substantial funding. Therefore, it is important that in the meanwhile, we aim to identify simple strategies, focussing on optimising efficiency of the available resources, which can be adopted in the ED here and now. METHODS: We made a careful analysis of inflow, throughput and outflow data of all 24,823 patients visiting the ED of a large teaching hospital in the year 2015, and looked in more detail at the 10 days with the longest average throughput times...
January 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29367203/implementation-and-improvement-of-pediatric-asthma-guideline-improves-hospital-based-care
#17
David P Johnson, Donald H Arnold, James C Gay, Alison Grisso, Michael G O'Connor, Ellen O'Kelley, Paul E Moore
BACKGROUND: Standardized pediatric asthma care has been shown to improve measures in specific hospital areas, but to our knowledge, the implementation of an asthma clinical practice guideline (CPG) has not been demonstrated to be associated with improved hospital-wide outcomes. We sought to implement and refine a pediatric asthma CPG to improve outcomes and throughput for the emergency department (ED), inpatient care, and the ICU. METHODS: An urban, quaternary-care children's hospital developed and implemented an evidence-based, pediatric asthma CPG to standardize care from ED arrival through discharge for all primary diagnosis asthma encounters for patients ≥2 years old without a complex chronic condition...
February 2018: Pediatrics
https://www.readbyqxmd.com/read/29352674/the-effect-of-vertical-split-flow-patient-management-on-emergency-department-throughput-and-efficiency
#18
John S Garrett, Colyn Berry, Hao Wong, Huanying Qin, Jeffery A Kline
BACKGROUND: To address emergency department overcrowding operational research seeks to identify efficient processes to optimize flow of patients through the emergency department. Vertical flow refers to the concept of utilizing and assigning patients virtual beds rather than to an actual physical space within the emergency department to care of low acuity patients. The aim of this study is to evaluate the impact of vertical flow upon emergency department efficiency and patient satisfaction...
January 11, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29335822/emergency-department-throughput-an-intervention
#19
Nowreen Haq, Rona Stewart-Corral, Eric Hamrock, Jamie Perin, Waseem Khaliq
Shortening emergency department (ED) boarding time and managing hospital bed capacity by expediting the inpatient discharge process have been challenging for hospitals nationwide. The objective of this study is was to explore the effect of an innovative prospective intervention on hospital workflow, specifically on early inpatient discharges and the ED boarding time. The intervention consisted of a structured nursing "admission discharge transfer" (ADT) protocol receiving new admissions from the ED and helping out floor nursing with early discharges...
January 15, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29330584/a-dedicated-neurologist-at-the-emergency-department-during-out-of-office-hours-decreases-patients-length-of-stay-and-admission-percentages
#20
M Christien van der Linden, Crispijn L van den Brand, Ido R van den Wijngaard, Roeline A Y de Beaufort, Naomi van der Linden, Korné Jellema
BACKGROUND: Emergency departments (EDs) worldwide face crowding, which hampers patient flow. In this study, the impact of a dedicated neurologist present at the ED on patient flow during out-of-office hours was assessed. METHODS: A cross-sectional, mixed methods study was undertaken at a Dutch ED, including a pre-post analysis of data of patients who had a primary neurological disease (n = 458) and staff surveys (n = 152). Descriptive statistics and content analysis were used for analyses...
March 2018: Journal of Neurology
keyword
keyword
61205
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"