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Ed overcrowding

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https://www.readbyqxmd.com/read/29922734/non-urgent-adult-patients-in-the-emergency-department-causes-and-patient-characteristics
#1
Hasan Idil, Turgay Yılmaz Kilic, İbrahim Toker, Kadriye Dura Turan, Murat Yesilaras
Objective: Non-urgent patients are one of the important causes of emergency department (ED) overcrowding. In this study, it is aimed to identify the characteristics of these patients and the reasons why they prefer the ED. Method: This study was conducted during regular office hours. The characteristics of non-urgent patients, their complaints, the frequency of visits to family physicians (FPs), the frequency of using the Central Hospital Appointment System (CHAS) and reasons for preferring the ED were questioned by a questionnaire...
June 2018: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29880260/a-different-crowd-a-different-crowding-level-the-predefined-thresholds-of-crowding-scales-may-not-be-optimal-for-all-emergency-departments
#2
M Christien Van Der Linden, Merel Van Loon, Menno I Gaakeer, John R Richards, Robert W Derlet, Naomi Van Der Linden
INTRODUCTION: Previous studies indicate that crowding scales may not perform well in low-volume emergency departments (EDs). In this study, face-validity of the Modified National ED OverCrowding Score (mNEDOCS) was assessed in a high-volume ED as well as in a low-volume ED. METHODS: A prospective observational cohort study was performed in the Netherlands. The correlation of the mNEDOCS with ED staff perceptions of crowding were assessed, using weighted Kappa (κ) and Pearson correlation...
June 4, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29857414/an-information-system-design-for-emergency-department-overcrowding-assessment
#3
Yiqing Zhuang, Xu Chen, Xiaohua Ge
This poster proposes an informatics report system designed to estimate the readiness of Emergency Departments (ED) to overcrowing and readiness of a real-time usage of medical response. This system can be installed with the applications on all kinds of electronic devices approved by the hospital. A automatically system generated electronic report can clearly and organized demonstrate the condition of ED, and offer the data to inform healthcare managers on decision making, and more importantly, improve the patient outcomes...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29715251/time-spent-in-the-emergency-department-and-outcomes-in-patients-with-severe-sepsis-and-septic-shock
#4
RaeAnn Hirschy, Ethan Sterk, Rachel Dobersztyn, Megan A Rech
A majority of patients with severe sepsis and septic shock are first evaluated in the emergency department (ED). Methods such as screening tools have proven advantageous in earlier identification, allowing for timely initiation of treatment. Delay in symptom presentation and ED overcrowding contribute to deferment of sepsis bundle components and admission. To examine the impact of time from ED arrival to inpatient admission on mortality and length of stay (LOS) in patients with severe sepsis or septic shock...
April 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29706806/factors-associated-with-emergency-room-visits-within-30-days-of-outpatient-foot-and-ankle-surgeries
#5
Naohiro Shibuya, Himani Patel, Colin Graney, Daniel C Jupiter
The number of emergency department (ED) visits within 30 days after elective surgery has been utilized as a quality measure by many institutions. The significance of the measure as a postoperative complication in foot and ankle surgery, and risk factors for it, are unknown. We conducted a retrospective cohort study involving 386 patients to determine risk factors associated with ED visits after outpatient foot and ankle surgeries. After adjusting for clinically relevant covariates, we found that previous ED visits within 6 months of surgery, and nonelective surgeries were associated with the postoperative ED visit...
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29706056/changes-in-medical-care-due-to-the-absence-of-internal-medicine-physicians-in-emergency-departments
#6
Kyoung Ho Kim, Jang Young Lee, Won Suk Lee, Won Young Sung, Sang Won Seo
Objective: Especially in emergency departments (EDs), a lack of internal medicine (IM) residents in charge causes difficulties in medical care and ED overcrowding. Thus, protocols without IM residents in EDs is needed. This study aimed to investigate changes in medical care when emergency medicine residents replaced the roles of IM residents. Methods: This study was conducted at a single-site ED of a university medical center. The study group contained patients admitted to the IM department between September and December 2015, during which IM residents were absent in the ED...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29701852/epidemiology-and-risk-factors-for-cryptosporidiosis-in-children-from-eight-low-income-sites-results-from-the-mal-ed-study
#7
Poonum S Korpe, Cristian Valencia, Rashidul Haque, Mustafa Mahfuz, Monica McGrath, Eric Houpt, Margaret Kosek, Benjamin J J McCormick, Pablo Penataro Yori, Sudhir Babji, Gagandeep Kang, Dennis Lang, Michael Gottlieb, Amidou Samie, Pascal Bessong, A S G Faruque, Esto Mduma, Rosemary Nshama, Alexandre Havt, Ila F N Lima, Aldo A M Lima, Ladaporn Bodhidatta, Ashish Shreshtha, William A Petri, Tahmeed Ahmed, Priya Duggal
Background: Cryptosporidium spp are enteric protozoa that cause significant morbidity and mortality in children worldwide. We characterized the epidemiology of Cryptosporidium in children from eight resource-limited sites of the MAL-ED study. Methods: Children were enrolled within 17 days of birth, and followed twice weekly for 24 months. Diarrheal and monthly surveillance stool samples were tested for Cryptosporidium by ELISA. Socioeconomic data were collected by survey and anthropometry was measured monthly...
April 26, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29665984/emergency-department-overcrowding-quality-improvement-in-a-taiwan-medical-center
#8
Chen-Mei Hsu, Li-Lin Liang, Yun-Te Chang, Wang-Chuan Juang
BACKGROUND/PURPOSE: Overcrowding of hospital emergency departments (ED) is a worldwide health problem. The Taiwan Joint Commission on Hospital Accreditation has stressed the importance of finding solutions to overcrowding, including, reducing the number of patients with >48 h stay in the ED. Moreover, the Ministry of Health and Welfare aims at transferring non-critical patients to district or regional hospitals. We report the results of our Quality Improvement Project (QIP) on ED overcrowding, especially focusing on reducing length of stay (LOS) in ED...
April 14, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29605480/emergency-department-boarding-and-adverse-hospitalization-outcomes-among-patients-admitted-to-a-general-medical-service
#9
Kito Lord, Vivek Parwani, Andrew Ulrich, Emily B Finn, Craig Rothenberg, Beth Emerson, Alana Rosenberg, Arjun K Venkatesh
OBJECTIVE: Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. METHOD: We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015...
March 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29601462/incident-reporting-to-improve-patient-safety-the-effects-of-process-variance-on-pediatric-patient-safety-in-the-emergency-department
#10
Karen J OʼConnell, Kathy N Shaw, Richard M Ruddy, Prashant V Mahajan, Richard Lichenstein, Cody S Olsen, Tomohiko Funai, Stephen Blumberg, James M Chamberlain
OBJECTIVE: Medical errors threaten patient safety, especially in the pediatric emergency department (ED) where overcrowding, multiple handoffs, and workflow interruptions are common. Errors related to process variance involve situations that are not consistent with standard ED operations or routine patient care. SETTING/PARTICIPANTS: We performed a planned subanalysis of the Pediatric Emergency Care Applied Research Network incident reporting data classified as process variance events...
April 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29573904/causes-of-emergency-department-overcrowding-and-blockage-of-access-to-critical-services-in-beijing-a-2-year-study
#11
Zhen Wang, Xiaying Xiong, Shuang Wang, Junguo Yan, Martin Springer, R P Dellinger
BACKGROUND: Emergency department (ED) overcrowding is a serious issue worldwide. OBJECTIVES: This study was done to evaluate the degree of overcrowding in local "teaching hospitals" in Beijing, and to ascertain the apparent root causes for the pervasive degree of overcrowding in these EDs. METHODS: This is a multicenter cross-sectional study. The studied population included all ED patients from 18 metropolitan teaching hospital EDs in Beijing for calendar years 2013 and 2014...
May 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29563151/emergency-department-overcrowding-a-survey-among-european-neurotrauma-centres
#12
Kimberley Bernadette Velt, Maryse Cnossen, Pleunie P M Rood, Ewout W Steyerberg, Suzanne Polinder, Hester F Lingsma
BACKGROUND: ED overcrowding is an increasing problem worldwide that may negatively affect quality of care and patient outcomes. We aimed to study ED overcrowding across European centres. METHODS: Questionnaires on structure and process of care, including crowding, were distributed to 68 centres participating in a large European study on traumatic brain injury (Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury). RESULTS: Of the 65 centres included in the analysis, 32 (49%) indicated that overcrowding was a frequent problem and 28 (43%) reported that patients were placed in hallways 'multiple times a day'; 27 (41%) stated that multiple times a day, there was no bed available when a patient needed to be admitted...
March 21, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29538401/impact-of-the-four-hour-rule-in-western-australian-hospitals-trend-analysis-of-a-large-record-linkage-study-2002-2013
#13
Hanh Ngo, Roberto Forero, David Mountain, Daniel Fatovich, Wing Nicola Man, Peter Sprivulis, Mohammed Mohsin, Sam Toloo, Antonio Celenza, Gerard Fitzgerald, Sally McCarthy, Ken Hillman
BACKGROUND: In 2009, the Western Australian (WA) Government introduced the Four-Hour Rule (FHR) program. The policy stated that most patients presenting to Emergency Departments (EDs) were to be seen and either admitted, transferred, or discharged within 4 hours. This study utilised de-identified data from five participating hospitals, before and after FHR implementation, to assess the impact of the FHR on several areas of ED functioning. METHODS: A state (WA) population-based intervention study design, using longitudinal data obtained from administrative health databases via record linkage methodology, and interrupted time series analysis technique...
2018: PloS One
https://www.readbyqxmd.com/read/29523559/incidence-of-delirium-in-the-canadian-emergency-department-and-its-consequences-on-hospital-length-of-stay-a-prospective-observational-multicentre-cohort-study
#14
Marcel Émond, Valérie Boucher, Pierre-Hugues Carmichael, Philippe Voyer, Mathieu Pelletier, Émilie Gouin, Raoul Daoust, Simon Berthelot, Marie-Eve Lamontagne, Michèle Morin, Stéphane Lemire, Thien Tuong Minh Vu, Alexandra Nadeau, Marcel Rheault, Lucille Juneau, Natalie Le Sage, Jacques Lee
OBJECTIVE: We aim to determine the incidence of delirium and describe its impacts on hospital length of stay (LOS) among non-delirious community-dwelling older adults with an 8-hour exposure to the emergency department (ED) environment. DESIGN: This is a prospective observational multicentre cohort study (March-July 2015). Patients were assessed two times per day during their entire ED stay and up to 24 hours on hospital ward. SETTING: The study took place in four Canadian EDs...
March 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29438575/primary-care-professionals-providing-non-urgent-care-in-hospital-emergency-departments
#15
REVIEW
Daniela Gonçalves-Bradley, Jaspreet K Khangura, Gerd Flodgren, Rafael Perera, Brian H Rowe, Sasha Shepperd
BACKGROUND: In many countries emergency departments (EDs) are facing an increase in demand for services, long waits, and severe crowding. One response to mitigate overcrowding has been to provide primary care services alongside or within hospital EDs for patients with non-urgent problems. However, it is unknown how this impacts the quality of patient care and the utilisation of hospital resources, or if it is cost-effective. This is the first update of the original Cochrane Review published in 2012...
February 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29417732/the-sydney-triage-to-admission-risk-tool-start-a-prospective-validation-study
#16
Anja A Ebker-White, Kendall J Bein, Michael M Dinh
OBJECTIVE: The present study aims to prospectively validate the Sydney Triage to Admission Risk Tool (START) to predict ED disposition. METHODS: This was a prospective validation study at two metropolitan EDs in Sydney, Australia. Consecutive triage encounters were observed by a trained researcher and START scores calculated. The primary outcome was patient disposition (discharge or inpatient admission) from the ED. Multivariable logistic regression was used to estimate area under curve of receiver operator characteristic (AUC ROC) for START scores as well as START score in combination with other variables such as frailty, general practitioner referral, overcrowding and major medical comorbidities...
February 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29401740/primary-care-comprehensiveness-can-reduce-emergency-department-visits-and-hospitalization-in-people-with-hypertension-in-south-korea
#17
Nak-Jin Sung, Yong-Jun Choi, Jae-Ho Lee
Hypertension has been the leading risk factor contributing to cardiovascular morbidity and mortality, which needs comprehensive measures to manage and can be controlled effectively in primary care. In the health care context of South Korea, where specialists can see patients directly at their own community clinics and there has been no consensus on the definition of primary care, the authors used the nationally representative 2013 Korea Health Panel data, categorized adults (≥18 years) with hypertension by types of usual source of care (USC), and analyzed the association of having a comprehensive community clinic (i...
February 5, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29401351/emergency-department-waiting-times-in-an-israeli-children-s-hospital-during-times-of-military-conflict
#18
Itai Shavit, Oren Feldman
Introduction: During military conflicts in southern Israel, many families moved north, and hospitals and primary care clinics under threat of missile attacks referred their patients to hospitals outside the combat zone, causing overcrowding of the emergency departments (ED). The study objective is to examine the effect of military conflicts on ED waiting time in a children's hospital outside the combat zone. Materials and Methods: A retrospective cohort study of patients admitted between January 2011 and December 2015 was conducted...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29380133/non-urgent-use-of-emergency-departments-populations-most-likely-to-overestimate-illness-severity
#19
Hans Andrews, Lawrence Kass
Patients' overestimation of their illness severity appears to contribute to the national epidemic of emergency department (ED) overcrowding. This study aims to elucidate which patient populations are more likely to have a higher estimation of illness severity (EIS). The investigator surveyed demographic factors of all non-urgent patients at an academic ED. The patients and physicians were asked to estimate the patients' illness severity using a 1-10 scale with anchors. The difference of these values was taken and compared across patient demographic subgroups using a 2-sample t-test...
January 29, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29352674/the-effect-of-vertical-split-flow-patient-management-on-emergency-department-throughput-and-efficiency
#20
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
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