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https://www.readbyqxmd.com/read/28534558/-proposing-a-physiological-model-for-emergency-department-operating-principles-classification-of-overcrowding-and-guidelines-for-redesign
#1
M Herrera Carranza, F Aguado Correa, N Padilla Garrido, F López Camacho
The operation of Emergency Departments (ED) is determined by demand, their own organizational structures and the connection to other medical care levels. When these elements are not simultaneous, it hinders patient flow and decreases capacity, making it necessary to employ a systemic approach to the chain of emergency care as a single operational entity. With this theoretical orientation, we suggest a conceptual model similar to the physiological cardiac output, in which the preload is the demand, the contractile or flow pump is the organizational structure, the afterload is the hospital, the pre-ED valve is primary care and outpatient emergencies, and the post-ED valve is the diagnostic support services and the specialist consultants...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28530136/elastography-a-practical-approach-barr-rg-ed-elastography-a-practical-approach-thieme-medical-publishers-inc-new-york-2016-178-pp-97816262232716-%C3%A2-109-99-hbk
#2
https://www.readbyqxmd.com/read/28527874/pressor-support-during-a-jarisch-herxheimer-reaction-after-initiation-of-treatment-for-weil-s-disease
#3
Randi Connor-Schuler, Anee Khan, Nikhil Goyal, Erin Zimny
We present a case of Weil's disease complicated by a Jarisch-Herxheimer reaction (JHR) after initiation of antibiotics while in the emergency department requiring invasive monitoring and vasopressor support. The case is followed by a brief review of the JHR which is rarely observed with treatment of leptospirosis. A healthy 28-year-old female who recently returned from the Caribbean presented to the emergency department with flu-like symptoms. The patient appeared jaundiced with conjunctival suffusion and was ultimately treated with the appropriate antibiotics for leptospirosis in the ED...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28527641/identifying-social-behavioral-health-needs-of-adults-with-sickle-cell-disease-in-the-emergency-department
#4
Sophia K Smith, Julia Johnston, Carlton Rutherford, Rachel Hollowell, Paula Tanabe
INTRODUCTION: Sickle cell disease (SCD) is a complex illness with many social-behavioral co-morbidities. The aim of this project was to describe unmet social-behavioral health needs for adults with SCD who presented to the emergency department for treatment of vaso-occlusive episodes (VOEs). METHODS: A descriptive study using 1:1 interviews during an ED visit for a VOE was conducted; a brief social behavioral health screening interview guide was used. A convenience sample of adults with SCD treated in the emergency department for a VOE were eligible for inclusion...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28527640/influences-on-patient-satisfaction-among-patients-who-use-emergency-departments-frequently-for-pain-related-complaints
#5
Patricia Newcomb, Marian Wilson, Ralph Baine, Terence McCarthy, Nicholas Penny, Caroline Nixon, Justin Orren
INTRODUCTION: The primary purpose of this study was to assess relationships between opioid prescribing practices, patient and ED attributes, and patient satisfaction ratings of nursing and physician care among patients with high utilization of the emergency department for pain relief. METHODS: A retrospective cohort study was conducted to examine 305 individual patient satisfaction surveys from users with high ED utilization for pain complaints. Responses were compared with an age-matched control group (n = 305) of nonfrequent ED users...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28526932/inpatient-addiction-consultation-for-hospitalized-patients-increases-post-discharge-abstinence-and-reduces-addiction-severity
#6
Sarah E Wakeman, Joshua P Metlay, Yuchiao Chang, Grace E Herman, Nancy A Rigotti
BACKGROUND: Alcohol and drug use results in substantial morbidity, mortality, and cost. Individuals with alcohol and drug use disorders are overrepresented in general medical settings. Hospital-based interventions offer an opportunity to engage with a vulnerable population that may not otherwise seek treatment. OBJECTIVE: To determine whether inpatient addiction consultation improves substance use outcomes 1 month after discharge. DESIGN: Prospective quasi-experimental evaluation comparing 30-day post-discharge outcomes between participants who were and were not seen by an addiction consult team during hospitalization at an urban academic hospital...
May 19, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28523476/impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#7
Richard B Balaban, Fang Zhang, Catherine E Vialle-Valentin, Alison A Galbraith, Marguerite E Burns, Marc R Larochelle, Dennis Ross-Degnan
BACKGROUND: With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. OBJECTIVE: To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. DESIGN: Randomized controlled trial conducted October 2011 through April 2013. PARTICIPANTS: Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28523265/prevalence-and-associated-factors-of-erectile-dysfunction-among-married-men-in-vietnam
#8
Thang Van Vo, Hue Dinh Hoang, Nhan Phuc Thanh Nguyen
BACKGROUND: Sexuality is an essential part of life; however, erectile dysfunction (ED) has been one of the most common complaints among men with sexual health issues all over the world. ED includes dysfunction in erection and penile erectile pain. In Vietnam, ED is a subject a not readily discussed. Thus, relatively little is known about ED among Vietnamese men. AIMS: To identify the prevalence of ED and its associated variables and the need for treatment of ED among married men in Vietnam...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28515805/is-computed-tomography-defined-obstruction-a-predictor-of-urological-intervention-in-emergency-department-patients-presenting-with-renal-colic
#9
Peter Alexander Massaro, Avinash Kanji, Paul Atkinson, Ryan Pawsey, Tom Whelan
INTRODUCTION: Our objective was to determine whether unilateral calculus-induced ureteric obstruction on computed tomography (CT) was independently associated with the need for urological intervention and 30-day return to the emergency department (ED). METHODS: We performed a retrospective cohort study of patients with symptomatic urinary calculi diagnosed by unenhanced helical CT. Stepwise regression analysis was used to determine the predictors of urological intervention and 30-day return to the ED...
March 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28514641/mapping-workforce-configuration-and-operational-models-in-australian-emergency-departments-a-national-survey
#10
Glenn Gardner, Anne Gardner, Sandy Middleton, Julie Considine, Gerard Fitzgerald, Luke Christofis, Anna Doubrovsky, Margaret Adams, Jane O'Connell
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs.Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28511702/what-is-the-evidence-for-the-management-of-patients-along-the-pathway-from-the-emergency-department-to-acute-admission-to-reduce-unplanned-attendance-and-admission-an-evidence-synthesis
#11
Sarah H Credé, Colin O'Keeffe, Suzanne Mason, Anthea Sutton, Emma Howe, Susan J Croft, Mike Whiteside
BACKGROUND: Globally, the rate of emergency hospital admissions is increasing. However, little evidence exists to inform the development of interventions to reduce unplanned Emergency Department (ED) attendances and hospital admissions. The objective of this evidence synthesis was to review the evidence for interventions, conducted during the patient's journey through the ED or acute care setting, to manage people with an exacerbation of a medical condition to reduce unplanned emergency hospital attendance and admissions...
May 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28509687/trust-in-the-medical-profession-among-adolescents-in-an-emergency-department
#12
Kelstan Lynch Ellis, Kimberly Randell, John Lantos, Melissa K Miller
OBJECTIVE: The aims of this study were to assess trust in the medical profession among adolescents in an urban pediatric emergency department (ED) and explore factors associated with trust. METHODS: We used a computerized survey to assess personal trust, perceived trust among family/friends, health care use, general and genital examination preferences, health behaviors, and demographics among youth aged 14 to 19 years. The primary outcome was the mean composite score of a validated 5-item scale...
May 15, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28506546/a-model-for-electronic-handoff-between-the-emergency-department-and-inpatient-units
#13
Leon D Sanchez, David T Chiu, Larry Nathanson, Steve Horng, Richard E Wolfe, Mark L Zeidel, Kirsten Boyd, Carrie Tibbles, Shelley Calder, Jane Dufresne, Julius J Yang
BACKGROUND: Patient handoffs between units can introduce risk and time delays. Verbal communication is the most common mode of handoff, but requires coordination between different parties. OBJECTIVE: We present an asynchronous patient handoff process supported by a structured electronic signout for admissions from the emergency department (ED) to the inpatient medicine service. METHODS: A retrospective review of patients admitted to the medical service from July 1, 2011 to June 30, 2015 at a tertiary referral center with 520 inpatient beds and 57,000 ED visits annually...
May 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28499358/can-we-predict-functional-decline-in-hospitalized-older-people-admitted-through-the-emergency-department-reanalysis-of-a-predictive-tool-ten-years-after-its-conception
#14
Isabelle De Brauwer, Pascale Cornette, Benoît Boland, Franck Verschuren, William D'Hoore
BACKGROUND: In the Emergency Department (ED), early and rapid identification of older people at risk of adverse outcomes, who could best benefit from complex geriatric intervention, would avoid wasting time, especially in terms of prevention of adverse outcomes, and ensure optimal orientation of vulnerable patients. We wanted to test the predictive ability of a screening tool assessing risk of functional decline (FD), named SHERPA, 10 years after its conception, and to assess the added value of other clinical or biological factors associated with FD...
May 12, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28499354/patient-and-care-characteristics-of-self-referrals-treated-by-the-general-practitioner-cooperative-at-emergency-care-access-points-in-the-netherlands
#15
Martijn Rutten, Fieke Vrielink, Marleen Smits, Paul Giesen
BACKGROUND: In the Netherlands, out-of-hours primary care is provided in general practitioner-cooperatives (GPCs). These are increasingly located on site and in collaboration with emergency departments of hospitals (ED). At such sites, also called emergency-care-access-points (ECAP), the GPC is generally responsible for the triage and treatment of self-referrals who used to attend the ED. To evaluate the effects and safety of this novel organisation, we studied the characteristics and the quality of care given by GPCs to self-referrals at ECAPs...
May 12, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28498199/incorporating-alternative-care-site-characteristics-into-estimates-of-substitutable-ed-visits
#16
Nathan Seth Trueger, Kao-Ping Chua, Aamir Hussain, Aisha T Liferidge, Stephen R Pitts, Jesse M Pines
BACKGROUND: Several recent efforts to improve health care value have focused on reducing emergency department (ED) visits that potentially could be treated in alternative care sites (ie, primary care offices, retail clinics, and urgent care centers). Estimates of the number of these visits may depend on assumptions regarding the operating hours and functional capabilities of alternative care sites. However, methods to account for the variability in these characteristics have not been developed...
May 11, 2017: Medical Care
https://www.readbyqxmd.com/read/28495903/health-care-service-and-outcomes-among-an-estimated-6-7-million-ambulatory-care-diabetic-foot-cases-in-the-u-s
#17
Grant H Skrepnek, Joseph L Mills, Lawrence A Lavery, David G Armstrong
OBJECTIVE: To evaluate ambulatory clinical cases of diabetic foot ulcers (DFUs) and diabetic foot infections (DFIs) in the U.S. from 2007 to 2013 and to assess outcomes of emergency department or inpatient (ED/IP) admission, number of clinic visits per year, and physician time spent per visit. RESEARCH DESIGN AND METHODS: A cross-sectional historical cohort analysis was conducted by using the nationally representative Centers for Disease Control and Prevention National Ambulatory Medical Care Survey data from 2007 to 2013, including patients age ≥18 years with diabetes and either DFIs or DFUs...
May 11, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28495813/trends-in-the-supply-of-california-s-emergency-departments-and-inpatient-services-2005-2014-a-retrospective-analysis
#18
Jessica L Chow, Matthew J Niedzwiecki, Renee Y Hsia
OBJECTIVES: Given increasing demand for emergency care, there is growing concern over the availability of emergency department (ED) and inpatient resources. Existing studies of ED bed supply are dated and often overlook hospital capacity beyond ED settings. We described recent statewide trends in the capacity of ED and inpatient hospital services from 2005 to 2014. DESIGN: Retrospective analysis. SETTING: Using California hospital data, we examined the absolute and per admission changes in ED beds and inpatient beds in all hospitals from 2005 to 2014...
May 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28494994/predicting-return-visits-to-the-emergency-department-for-pediatric-patients-applying-supervised-learning-techniques-to-the-taiwan-national-health-insurance-research-database
#19
Ya-Han Hu, Chun-Tien Tai, Solomon Chih-Cheng Chen, Hai-Wei Lee, Sheng-Feng Sung
BACKGROUND AND OBJECTIVE: Return visits (RVs) to the emergency department (ED) consume medical resources and may represent a patient safety issue. The occurrence of unexpected RVs is considered a performance indicator for ED care quality. Because children are susceptible to medical errors and utilize considerable ED resources, knowing the factors that affect RVs in pediatric patients helps improve the quality of pediatric emergency care. METHODS: We collected data on visits made by patients aged ≤18years to EDs from the National Health Insurance Research Database...
June 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28493596/overcoming-the-tower-of-babel-in-medical-science-by-finding-the-equator-research-reporting-guidelines
#20
Christopher R Carpenter, Zachary F Meisel
You are hosting a journal club on chest pain management in the emergency department (ED) for colleagues and trainees in your department. Interested in understanding the history of cardiac biomarkers to evaluate ED patients with chest pain, you search PubMed using the combination of terms "cardiac biomarker", "chest pain", and "emergency department". Your search nets no studies prior to 2002 which you doubt is accurate, so you take the old-fashioned approach and start flipping through the oldest issues of emergency medicine journals at your local medical school library...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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