keyword
MENU ▼
Read by QxMD icon Read
search

Overcrowding in emergency departments

keyword
https://www.readbyqxmd.com/read/27885343/qualitative-inquiry-into-challenges-experienced-by-registered-general-nurses-in-the-emergency-department-a-study-of-selected-hospitals-in-the-volta-region-of-ghana
#1
Confidence Alorse Atakro, Jerry Paul Ninnoni, Peter Adatara, Janet Gross, Michael Agbavor
Registered General Nurses (RGNs) play crucial roles in emergency departments (EDs). EDs in Ghana are primarily staffed by RGNs who have had no additional formal education in emergency care. Additionally, basic, master's, or doctoral level nursing education programs provide limited content on the complexities of emergency nursing. Nurses in EDs are affected by many challenges such as growing patient population, financial pressures, physical violence, verbal abuse, operational inefficiencies, overcrowding, and work overload...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27856953/door-to-imaging-time-for-acute-stroke-patients-is-adversely-affected-by-emergency-department-crowding
#2
Martin A Reznek, Evangelia Murray, Marguerite N Youngren, Natassia T Durham, Sean S Michael
BACKGROUND AND PURPOSE: National guidelines call for door-to-imaging time (DIT) within 25 minutes for suspected acute stroke patients. Studies examining factors that affect DIT have focused primarily on stroke-specific care processes and patient-specific factors. We hypothesized that emergency department (ED) crowding is associated with longer DIT. METHODS: We conducted a retrospective investigation of 1 year of consecutive patients in our prospective Code Stroke registry, which included all ED stroke team activations...
November 17, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27836151/violence-in-the-emergency-department
#3
REVIEW
Keith R Stowell, Nolan P Hughes, John S Rozel
Violence is common in the emergency department (ED). The ED setting has numerous environmental risk factors for violence, including poor staffing, lack of privacy, overcrowding, and ready availability of nonsecured equipment that can be used as weapons. Strategies can be taken to mitigate the risk of violence toward health care workers, including staff training, changes to the ED layout, appropriate use of security, and policy-level changes. Health care providers in the ED should be familiar with local case law and standards related to the duty to warn third parties when a violent threat is made by a patient...
December 2016: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/27831655/emergency-department-crowding-and-hospital-bed-shortage-is-lean-a-smart-answer-a-systematic-review
#4
S Bucci, A G de Belvis, S Marventano, A C De Leva, M Tanzariello, M L Specchia, W Ricciardi, F Franceschi
OBJECTIVE: Emergency Departments (EDs) worldwide face the challenges of crowding, waiting times, and cost containment. This review aims to provide a synthesis of the current literature focused on how Lean Thinking Principles and tools can be applied in an ED to address overcrowding and hospital admissions. MATERIALS AND METHODS: Primary studies showing Lean interventions and implementation in ED visits, not requiring additional resources measuring specific outcomes (i...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27829785/chronic-pain-in-the-emergency-department-a-pilot-mixed-methods-cross-sectional-study-examining-patient-characteristics-and-reasons-for-presentations
#5
Patricia A Poulin, Jennifer Nelli, Steven Tremblay, Rebecca Small, Myka B Caluyong, Jeffrey Freeman, Heather Romanow, Yehudis Stokes, Tia Carpino, Amanda Carson, Yaadwinder Shergill, Ian G Stiell, Monica Taljaard, Howard Nathan, Catherine E Smyth
Background. Chronic pain (CP) accounts for 10-16% of emergency department (ED) visits, contributing to ED overcrowding and leading to adverse events. Objectives. To describe patients with CP attending the ED and identify factors contributing to their visit. Methods. We used a mixed-method design combining interviews and questionnaires addressing pain, psychological distress, signs of opioid misuse, and disability. Participants were adults who attended the EDs of a large academic tertiary care center for their CP problem...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27806487/evaluation-of-the-patients-queue-status-at-emergency-department-of-nemazee-hospital-and-how-to-decrease-it-2014
#6
Mehrdad Askarian, Seyed Ali Hesami, Erfan Kharazmi, Nahid Hatam, Hourvash Akbari Haghighinejad, Mina Danaei
BACKGROUND: Patients, who seek care in emergency department, are waiting in queue and the health care provision in the department seems to be too overcrowded; the extended waiting time increases dissatisfaction and delays admission of new patients. In most of the hospitals considered to be overcrowded, the discharge rate of patients is managed by the use of "theory of queues". This study was done to observe waiting time of patients in emergency department by "queue theory analysis" and computer simulator in an Iranian hospital...
July 6, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27796707/comparison-of-clinical-based-and-ecg-based-triage-of-acute-chest-pain-in-the-emergency-department
#7
Melanie Dechamps, Diego Castanares-Zapatero, Patrick Vanden Berghe, Philippe Meert, Alessandro Manara
In the Emergency Department, chest pain triage systems are based on either clinical features or ECG recording. In this prospective, single-center, observational study, we aimed to compare the diagnostic performance of these triage systems in distinguishing acute coronary syndromes (ACS) from diseases of mild severity. Patients were sorted into the triage systems based on collected data at admission and on a systematic 12-lead ECG performed at triage. The final diagnosis was determined after a 30-day follow-up...
October 28, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27765045/individual-predictors-of-frequent-emergency-department-use-a-scoping-review
#8
Cynthia Krieg, Catherine Hudon, Maud-Christine Chouinard, Isabelle Dufour
BACKGROUND: A small proportion of patients use an excessively large amount of emergency care resources which often results in emergency department (ED) overcrowding, decreased quality of care and efficiency. There is a need to better identify these patients in order to target those who will benefit most from interventions adapted to their specific needs. We aimed to identify the predictive factors of short-term frequent use of ED (over a 1-year period) and chronic frequent use of ED (over a multiple-year period) and to highlight recurring characteristics in patients...
October 20, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27744236/does-the-extension-of-primary-care-practice-opening-hours-reduce-the-use-of-emergency-services
#9
Matteo Lippi Bruni, Irene Mammi, Cristina Ugolini
Overcrowding in emergency departments generates potential inefficiencies. Using regional administrative data, we investigate the impact that an increase in the accessibility of primary care has on emergency visits in Italy. We consider two measures of avoidable emergency visits recorded at list level for each General Practitioner. We test whether extending practices' opening hours to up to 12 hours/day reduces the inappropriate utilization of emergency services. Since subscribing to the extension program is voluntary, we account for the potential endogeneity of participation in a count model for emergency admissions in two ways: first, we use a two-stage residual inclusion approach...
October 8, 2016: Journal of Health Economics
https://www.readbyqxmd.com/read/27687168/effect-of-a-multi-diagnosis-observation-unit-on-emergency-department-length-of-stay-and-inpatient-admission-rate-at-two%C3%A2-canadian-hospitals
#10
Amy H Y Cheng, Neil G Barclay, Riyad B Abu-Laban
BACKGROUND: Observation units (OUs) have been shown to reduce emergency department (ED) lengths of stay (LOS) and admissions. Most published studies have been on OUs managing single complaints. OBJECTIVE: Our aim was to determine whether an OU reduces ED LOS and hospital admission rates for adults with a variety of presenting complaints. METHODS: We comparatively evaluated two hospitals in British Columbia, Canada (hereafter ED A and ED B) using a pre-post design...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27658706/primary-triage-nurses-do-not-divert-patients-away-from-the-emergency-department-at-times-of-high-in-hospital-bed-occupancy-a-retrospective-cohort-study
#11
Mathias C Blom, Karin Erwander, Lars Gustafsson, Mona Landin-Olsson, Fredrik Jonsson, Kjell Ivarsson
BACKGROUND: Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs. In short, primary triage means that a nurse separately evaluates patients who present in the Emergency Department (ED) and either refers them to primary care or discharges them home, if their complaints are perceived as being of low acuity. The aim of the present study is to elucidate whether high levels of in-hospital bed occupancy are associated with decreased permeability in primary triage...
September 22, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27648902/increasing-the-number-of-certified-registered-nurses-in-an-emergency-department-a-cohort-program-implementation
#12
Paula M Neira, Barbara Maliszewski, RaniMaria Toledo, Kimberly Borries, Diana-Lyn Baptiste
Nationally, hospital emergency departments are met with challenges because of increasing patient demands, overcrowding, and the need to protect patient safety. It is imperative that frontline emergency department nurses are prepared to meet the complex needs of diverse patient populations by having appropriate continuing education, training, and institutional resources. Professional certification is associated with improved patient safety, higher organizational performance scores, professional growth, and credibility among nurses...
September 2016: Journal for Nurses in Professional Development
https://www.readbyqxmd.com/read/27640310/-care-in-a-chair-the-impact-of-an-overcrowded-emergency-department-on-the-time-to-treatment-and-length-of-stay-of-self-presenting-patients-with-abdominal-pain
#13
Ben Smith, Stephane Bouchoucha, Elizabeth Watt
OBJECTIVES: The aim in this study was to investigate the impact of overcrowding on the Australasian Triage Score's (ATS) time to treatment target and the National Emergency Access Target (NEAT) for patients who self-present to the Emergency Department (ED) with abdominal pain. BACKGROUND: The causes and effects of ED overcrowding have been well described in the literature. It is a widespread phenomenon throughout the world and it can cause serious harm to patients and have a negative impact on access to emergency care...
September 15, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/27623330/-faintness-in-emergency-departments-is-frequent-benign-but-expensive-an-epidemiologic-study-of-hospitalization-s-risk-factors-to-reduce-overcrowdings-of-emergency-departments
#14
E Gedda, A Robbins, M Hentzien, A Giltat, V Pinel-Petit, J Souille, Y N'Guyen
INTRODUCTION: We assessed (i) the frequency of consultations for faintness in the Emergency department (ED) of a University hospital centre (UHC), (ii) clinical epidemiology and (iii) cost of faintness, taking a particular interest into the determining risk factors for hospitalization. METHODS: This epidemiological study has been conducted retrospectively, from data obtained for every patient having consulted for faintness in ED of Reims UHC (01/01/12-03/31/12)...
September 9, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/27544412/agents-endowed-with-uncertainty-management-behaviors-to-solve-a-multiskill-healthcare-task-scheduling
#15
Sarah Ben Othman, Hayfa Zgaya, Slim Hammadi, Alain Quilliot, Alain Martinot, Jean-Marie Renard
Health organizations are complex to manage due to their dynamic processes and distributed hospital organization. It is therefore necessary for healthcare institutions to focus on this issue to deal with patients' requirements. We aim in this paper to develop and implement a management decision support system (DSS) that can help physicians to better manage their organization and anticipate the feature of overcrowding. Our objective is to optimize the pediatric emergency department (PED) functioning characterized by stochastic arrivals of patients leading to its services overload...
August 17, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27532467/the-effects-of-emergency-department-overcrowding-on-admitted-patient-outcomes-a-systematic-review-protocol
#16
Eduardo Santos, Daniela Cardoso, Paulo Queirós, Madalena Cunha, Manuel Rodrigues, João Apóstolo
The objective of this review is to identify the effects of emergency department (ED) overcrowding on admitted patient outcomes.More specifically, the questions are: does ED overcrowding increase the admitted patient's mortality? Does ED overcrowding increase the admitted patient's hospital length-of-stay? Does ED overcrowding increase the delay in door-to-needle time to treatment (time to antibiotic, time to thrombolysis and time to analgesic)?
May 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27522452/predictors-of-emergency-department-referral-in-patients-using-out-of-hours-primary-care-services
#17
Maria Paola Scapinello, Andrea Posocco, Irene De Ronch, Francesco Castrogiovanni, Gianluca Lollo, Guglielmo Sergi, Iginio Tomaselli, Loris Tonon, Marco Solmi, Stefano Traversa, Vincenzo Zambianco, Nicola Veronese
BACKGROUND: Out of hours (OOH) doctors could manage many cases limiting the inappropriate accesses to ED. However the possible determinants of referral to ED by OOH doctors are poorly studied. We aimed to characterize patients referred from the OOH to ED service in order to explore the gate-keeping role of OOH service for hospital emergency care and to facilitate future research in improving its cost-effectiveness. METHODS: A retrospective study was made through data collection of 5217 contacts in a local OOH service in the North-East of Italy (from 10/01/2012 to 03/31/2013)...
September 2016: Health Policy
https://www.readbyqxmd.com/read/27507157/using-systems-thinking-to-identify-workforce-enablers-for-a-whole-systems-approach-to-urgent-and-emergency-care-delivery-a-multiple-case-study
#18
Kim Manley, Anne Martin, Carolyn Jackson, Toni Wright
BACKGROUND: Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. METHODS: A multiple case study design framed around systems thinking was conducted in South East England across one Trust consisting of five hospitals, one community healthcare trust and one ambulance trust...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27503862/determinants-of-out-of-hours-service-users-potentially-inappropriate-referral-or-non-referral-to-an-emergency-department-a-retrospective-cohort-study-in-a-local-health-authority-veneto-region-italy
#19
Alessandra Buja, Roberto Toffanin, S Rigon, P Sandonà, T Carrara, G Damiani, V Baldo
BACKGROUND: A growing presence of inappropriate patients has been recognised as one of the main factors influencing emergency department (ED) overcrowding, which is a very widespread problem all over the world. On the other hand, out-of-hours (OOH) physicians must avoid delaying the diagnostic and therapeutic course of patients with urgent medical conditions. The aim of this study was to analyse the appropriateness of patient management by OOH services, in terms of their potentially inappropriate referral or non-referral of non-emergency cases to the ED...
2016: BMJ Open
https://www.readbyqxmd.com/read/27473424/-one-way-street-streamlined-admission-of-critically-ill-trauma-patients-reduces-emergency-department-length-of-stay
#20
Eva Fuentes, Jean-Francois Shields, Nandan Chirumamilla, Myriam Martinez, Haytham Kaafarani, Daniel Dante Yeh, Benjamin White, Michael Filbin, Christopher DePesa, George Velmahos, Jarone Lee
Emergency department (ED) overcrowding remains a significant problem in many hospitals, and results in multiple negative effects on patient care outcomes and operational metrics. We sought to test whether implementing a quality improvement project could decrease ED LOS for trauma patients requiring an ICU admission from the ED, specifically by directly admitting critically ill trauma patients from the ED CT scanner to an ICU bed. This was a retrospective study comparing patients during the intervention period (2013-2014) to historical controls (2011-2013)...
July 29, 2016: Internal and Emergency Medicine
keyword
keyword
69452
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"