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Overcrowding in emergency departments

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https://www.readbyqxmd.com/read/29032791/deconstructing-the-4-h-rule-for-access-to-emergency-care-and-putting-patients-first
#1
Ian Scott, Clair Sullivan, Andrew Staib, Anthony Bell
Evidence suggests improved outcomes for patients requiring emergency admission to hospital are associated with improved emergency department (ED) efficiency and lower transit times. Factors preventing timely transfers of emergency patients to in-patient beds across the ED-in-patient interface are major causes for ED crowding, for which several remedial strategies are possible, including parallel processing of probable admissions, direct-to-ward admissions and single-point medical registrars for receiving and processing all referrals directed at specific speciality units...
October 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29029061/effects-of-access-to-radiology-in-out-of-hours-primary-care-in-the-netherlands-a-prospective-observational-study
#2
Martijn Hendrik Rutten, Marleen Smits, Yvonne Anthonia Sebastiana Peters, Willem Jan Jozef Assendelft, Gert Pieter Westert, Paul Hendrikus Josephus Giesen
Background: In the Netherlands, out-of-hours primary care is provided in general-practitioner-cooperatives (GPCs). These are increasingly located on site with emergency departments (ED), forming Emergency-Care-Access-Points (ECAP). A more efficient and economical organization of out-of-hours primary emergency care could be realized by increased collaboration at an ECAP. In this study, we compared the effects of different models with respect to access to (hospital) radiology by the GPC...
September 28, 2017: Family Practice
https://www.readbyqxmd.com/read/28992161/the-role-of-patient-perception-of-crowding-in-the-determination-of-real-time-patient-satisfaction-at-emergency-department
#3
Hao Wang, Jeffrey A Kline, Bradford E Jackson, Richard D Robinson, Matthew Sullivan, Marcus Holmes, Katherine A Watson, Chad D Cowden, Jessica Laureano Phillips, Chet D Schrader, JoAnna Leuck, Nestor R Zenarosa
Objective: To evaluate the associations between real-time overall patient satisfaction and Emergency Department (ED) crowding as determined by patient percepton and crowding estimation tool score in a high-volume ED. Design: A prospective observational study. Setting: A tertiary acute hospital ED and a Level 1 trauma center. Participants: ED patients. Intervention(s): Crowding status was measured by two crowding tools [National Emergency Department Overcrowding Scale (NEDOCS) and Severely overcrowded-Overcrowded-Not overcrowded Estimation Tool (SONET)] and patient perception of crowding surveys administered at discharge...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28970026/the-impact-of-the-improvement-in-internal-medicine-consultation-process-on-emergency-department-length-of-stay
#4
Sangheon Shin, Soo Hoon Lee, Dong Hoon Kim, Seong Chun Kim, Tae Yun Kim, Changwoo Kang, Jin Hee Jeong, Daesung Lim, Yong Joo Park, Sang Bong Lee
INTRODUCTION: Although consultations are essential for delivering safe, high-quality care to patients in emergency departments, they contribute to emergency department patient flow problems and overcrowding which is associated with several adverse outcomes, such as increases in patient mortality and poor quality care. This study aimed to investigate how time flow metrics including emergency department length of stay is influenced by changes to the internal medicine consultation policy...
September 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28924304/nedocs-vs-subjective-evaluation-%C3%A2-is-the-health-personnel-of-the-emergency-department-aware-of-its-overcrowding
#5
Mauricio Garcia-Romero, Claudia Geraldine Rita-Gáfaro, Jairo Quintero-Manzano, Anderson Bermon Angarita
INTRODUCTION: An emergency department (ED) is considered to be "overcrowded" when the number of patients exceeds its treatment capacity and it does not have the conditions to meet the needs of the next patient to be treated. This study evaluates overcrowding in the emergency department of a hospital in Colombia. OBJECTIVE: To compare the objective NEDOCS scale with a subjective evaluation by ED health staff in order to evaluate the differences between the two. METHODS: The NEDOCS scale was applied and a subjective overcrowding survey was administered to the medical staff and the charge nurse on duty 6 times per day (6:00 a...
June 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/28924282/overcrowding-and-possible-solutions-for-a-busy-paediatric-emergency-department
#6
Muhammad Irfan Habib, Khalid Mehmood Khan
OBJECTIVE: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions. METHODS: This retrospective study was conducted at the National Institute of Child Health, Karachi, and comprised data of all patients presenting to the emergency department from November 2014 to January 2015. Data was collected through the health management information system which generates daily report of patients. Patients who stayed at the emergency department for 4 or more hours were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28898330/-analysis-of-crowding-in-an-adult-emergency-department-of-a-tertiary-university-hospital
#7
Diego Hernán Giunta, Ana Soledad Pedretti, Cristina María Elizondo, María Florencia Grande Ratti, Fernán González Bernaldo de Quiros, Gabriel Darío Waisman, Hector José Peroni, Bernardo Martínez
BACKGROUND: Crowding in Emergency Departments (ED), results from the imbalance between the simultaneous demand for health care and the ability of the system to respond. The NEDOCS scale (National Emergency Department Crowding Scale) measures the degree of crowding in an ED. AIM: To describe ED Crowding characteristics, using the NEDOCS scale, in an Argentinean hospital. MATERIAL AND METHODS: A retrospective cohort study was conducted with all adult patient consultations between July 2013 and July 2014 at the ED of Hospital Italiano de Buenos Aires...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28870249/improving-emergency-department-radiology-transportation-time-a-successful-implementation-of-lean-methodology
#8
Eveline A Hitti, Ghada R El-Eid, Hani Tamim, Rana Saleh, Miriam Saliba, Lena Naffaa
BACKGROUND: Emergency Department overcrowding has become a global problem and a growing safety and quality concern. Radiology and laboratory turnaround time, ED boarding and increased ED visits are some of the factors that contribute to ED overcrowding. Lean methods have been used in the ED to address multiple flow challenges from improving door-to-doctor time to reducing length of stay. The objective of this study is to determine the effectiveness of using Lean management methods on improving Emergency Department transportation times for plain radiography...
September 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28855774/studying-the-variability-in-patient-inflow-and-staffing-trends-on-sundays-versus-other-days-in-the-academic-emergency-department
#9
K T Madavan Nambiar, Nisanth Menon Nedungalaparambil, Ottapura Prabhakaran Aslesh
BACKGROUND: Resource limitation, staff deficiency, and variability in patient inflow contribute to emergency department (ED) overcrowding, associated with delayed care, poor care, and poor patient outcomes. This study seeks to describe and analyze patient inflow variability and staffing trends on Sundays versus other days in a tertiary academic ED from South India. METHODS: Patient inflow and staffing data for 2 years were collected from hospital records, cross-checked, and statistically analyzed using Epi Info 7...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28834070/patient-navigation-for-patients-frequently-visiting-the-emergency-department-a-randomized-controlled-trial
#10
David Seaberg, Stanton Elseroad, Michael Dumas, Sudave Mendiratta, Jessica Whittle, Cheryl Hyatte, Jan Keys
BACKGROUND: ED super-utilizers (patients with 5 or more visits/year) comprise only 5% of the patients seen yet comprise 25% of total ED visits. Though the reasons for this are multifactorial, the cost to the patient and the community is exceedingly high. The cost is not just monetary; care of these patients is inappropriately fragmented and their presence in the ED may contribute to overcrowding affecting the community's emergency readiness. Previous studies using staff trained to help patients navigate their care options have had conflicting results...
August 21, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28741875/depression-and-anxiety-among-emergency-department-patients-utilization-and-barriers-to-care
#11
Beau Abar, Ashley Holub, Joseph Lee, Vincent DeRienzo, Flavia Nobay
BACKGROUND: Anxiety and depression rates among emergency department (ED) patients are substantially higher than those in the general population. Additionally, those with mental health issues often have difficulty accessing care. Unfortunately, issues of anxiety and depression are frequently not addressed in the ED due to competing care priorities. This may lead to increased burden and overcrowding in EDs. OBJECTIVE: This study related anxiety and depression with ED utilization and perceived barriers to care...
July 25, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28705743/the-influence-of-crowding-on-clinical-practice-in-the-emergency-department
#12
I-Min Chiu, Yan-Ren Lin, Yuan-Jhen Syue, Chia-Te Kung, Kuan-Han Wu, Chao-Jui Li
BACKGROUND: This study aimed to clarify the association between the crowding and clinical practice in the emergency department (ED). METHODS: This 1-year retrospective cohort study conducted in two EDs in Taiwan included 70,222 adult non-trauma visits during the day shift between July 1, 2011, and June 30, 2012. The ED occupancy status, determined by the number of patients staying during their time of visit, was used to measure crowding, grouped into four quartiles, and analyzed in reference to the clinical practice...
July 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28688771/optimal-measurement-interval-for-emergency-department-crowding-estimation-tools
#13
Hao Wang, Rohit P Ojha, Richard D Robinson, Bradford E Jackson, Sajid A Shaikh, Chad D Cowden, Rath Shyamanand, JoAnna Leuck, Chet D Schrader, Nestor R Zenarosa
STUDY OBJECTIVE: Emergency department (ED) crowding is a barrier to timely care. Several crowding estimation tools have been developed to facilitate early identification of and intervention for crowding. Nevertheless, the ideal frequency is unclear for measuring ED crowding by using these tools. Short intervals may be resource intensive, whereas long ones may not be suitable for early identification. Therefore, we aim to assess whether outcomes vary by measurement interval for 4 crowding estimation tools...
July 6, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28676415/emergency-department-flow-measures-for-adult-and-pediatric-patients-in-british-columbia-and-ontario-a-retrospective-repeated-cross-sectional-study
#14
Gregory Georgio, Astrid Guttmann, Quynh H Doan
BACKGROUND: Evidence suggests emergency department (ED) overcrowding is associated with poor health outcomes. Children comprise 20-25% of general ED visits, yet few studies have examined the differential impact of ED overcrowding on pediatric and adult populations. OBJECTIVE: The primary objective of this study was to compare flow measures, such as wait time to see a physician, length of stay (LOS), and rate of patients leaving without being seen by a physician (LWBS) between adults and children in British Columbia and Ontario, clustered by province, and then stratified by acuity level during the study period...
July 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28676296/contributing-factors-of-frequent-use-of-the-emergency-department-a-synthesis
#15
REVIEW
Timothy R Burns
INTRODUCTION: Overcrowding in emergency departments is an issue that has a negative impact worldwide. As attendance in emergency departments has increased, the ability to provide critical services to patients suffering from actual medical emergencies in a timely manner has decreased as these departments are many times at or over capacity. One patient population whose negative influence has been researched with regard to their impact on the overcrowding issue is that of the frequent user...
July 1, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28624270/implementation-and-evaluation-of-a-navigator-role-to-improve-emergency-department-throughput
#16
Paul Fulbrook, Melanie Jessup, Frances Kinnear
BACKGROUND: Emergency department overcrowding impacts patients, staff, and quality of care, and there is government pressure to optimize throughput and reduce waiting times. One solution for improving patient flow is the emerging 'navigator' role: a nurse that supports staff in care delivery; facilitating efficient and timely patient movement through the emergency department. METHODS: A 20-week project was implemented to evaluate an emergency department nurse navigator role...
August 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28575307/identified-transmission-dynamics-of-middle-east-respiratory-syndrome-coronavirus-infection-during-an-outbreak-implications-of-an-overcrowded-emergency-department
#17
Thamer H Alenazi, Hussain Al Arbash, Aiman El-Saed, Majid M Alshamrani, Henry Baffoe-Bonnie, Yaseen M Arabi, Sameera M Al Johani, Ra'ed Hijazi, Adel Alothman, Hanan H Balkhy
A total 130 cases of Middle East respiratory syndrome coronavirus were identified during a large hospital outbreak in Saudi Arabia; 87 patients and 43 healthcare workers. The majority (80%) of transmission was healthcare-acquired (HAI) infection, with 4 generations of HAI transmission. The emergency department was the main location of exposure.
August 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28571105/visualising-emergency-department-capacity-in-an-emergency-department-capacity-clock-a-novel-tool-to-assess-and-communicate-overcrowding-and-access-block
#18
Ohad Dar, Jacques Loubser
Hospital-wide engagement is required to alleviate the problem of ED crowding and its associated adverse effects. To this end, the article describes a novel visualisation termed 'the ED Capacity Clock', which can be formatted using business intelligence software. This radial diagram represents ED capacity and its consumption in a format that can be understood intuitively and at a glance. The ED Capacity Clock is designed to promote common understanding and discussion between relevant hospital services and also acts as an auditing tool to monitor processes implemented to alleviate ED crowding...
June 1, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28557729/early-prediction-model-of-patient-hospitalization-from-the-pediatric-emergency-department
#19
Yuval Barak-Corren, Andrew M Fine, Ben Y Reis
BACKGROUND AND OBJECTIVES: Emergency departments (EDs) in the United States are overcrowded and nearing a breaking point. Alongside ever-increasing demand, one of the leading causes of ED overcrowding is the boarding of hospitalized patients in the ED as they await bed placement. We sought to develop a model for early prediction of hospitalizations, thus enabling an earlier start for the placement process and shorter boarding times. METHODS: We conducted a retrospective cohort analysis of all visits to the Boston Children's Hospital ED from July 1, 2014 to June 30, 2015...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28546986/factors-affecting-the-overcrowding-in-outpatient-healthcare
#20
Mohammadkarim Bahadori, Ehsan Teymourzadeh, Ramin Ravangard, Mehdi Raadabadi
BACKGROUND: The expansion of outpatient services and the desire to provide more outpatient care than inpatient care create some problems such as the overcrowding in the outpatient clinics. Given the importance of overcrowding in the outpatient clinics, this qualitative study aimed to determine the factors influencing the overcrowding in the specialty and subspecialty clinic of a teaching hospital. MATERIALS AND METHODS: This was a qualitative study conducted in the specialty and subspecialty clinic of a hospital using content analysis method in the period of January to March 2014...
2017: Journal of Education and Health Promotion
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