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Ed overcrowding

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https://www.readbyqxmd.com/read/28275860/parameters-affecting-length-of-stay-in-a-pediatric-emergency-department-a-retrospective-observational-study
#1
Kevin D Hofer, Rotraud K Saurenmann
Prolonged emergency department (ED) length of stay (LOS) is used as a proxy for ED overcrowding and is associated with adverse outcomes of patients requiring therapy and reduced patient satisfaction. Our aim was to identify and quantify variables which affect ED-LOS. Patients admitted to the pediatric ED of a large regional Swiss hospital during a 1-year period were analyzed for LOS (in minutes). Predictor variables included patient-associated parameters (time of admission and discharge, ED occupancy, triage score, diagnosis, and demographic data) and external factors (weekday, time, and season)...
March 8, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28274646/general-characteristics-and-activity-of-emergency-department-short-stay-units-in-spanish-hospitals
#2
Carles Ferré, Ferran Llopis, Francisco Javier Martín-Sánchez, Gonzalo Sempere, Pere Llorens, Carmen Navarro, Mikel Martínez-Ortiz, Antoni Juan
BACKGROUND: Emergency Department (ED) overcrowding mainly due to the lack of access to inpatient beds negatively affects safety and quality of care. Implementation of ED short-stay units (EDSSUs) may help to mitigate this situation. OBJECTIVES: To describe the general characteristics and evaluate the activity of EDSSUs in Spanish hospitals. METHODS: This is a cross-sectional study. A questionnaire was sent to coordinators responsible for the EDSSUs identified among Spanish hospitals appearing on the Ministry of Health Web page...
March 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28241931/text-mining-approach-to-predict-hospital-admissions-using-early-medical-records-from-the-emergency-department
#3
Filipe R Lucini, Flavio S Fogliatto, Giovani J C da Silveira, Jeruza L Neyeloff, Michel J Anzanello, Ricardo de S Kuchenbecker, Beatriz D Schaan
OBJECTIVE: Emergency department (ED) overcrowding is a serious issue for hospitals. Early information on short-term inward bed demand from patients receiving care at the ED may reduce the overcrowding problem, and optimize the use of hospital resources. In this study, we use text mining methods to process data from early ED patient records using the SOAP framework, and predict future hospitalizations and discharges. DESIGN: We try different approaches for pre-processing of text records and to predict hospitalization...
April 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28228344/emergency-department-return-visits-within-a-large-geographic-area
#4
Mimi Truong, Garth Meckler, Quynh H Doan
BACKGROUND: Return visits to the emergency department (RTED) contribute to overcrowding and may be a quality of care indicator. Previous studies focused on factors predicting returns to and from the same center. Little is known about RTEDs across a range of community and specialty hospitals within a large geographic area. OBJECTIVE: We sought to measure the frequency of pediatric RTEDs and describe their directional pattern across centers in a large catchment area...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28151752/influences-on-emergency-department-length-of-stay-for-older-people
#5
Maryann Street, Mohammadreza Mohebbi, Debra Berry, Anthony Cross, Julie Considine
OBJECTIVE: The aim of this study was to examine the influences on emergency department (ED) length of stay (LOS) for older people and develop a predictive model for an ED LOS more than 4 h. METHODS: This retrospective cohort study used organizational data linkage at the patient level from a major Australian health service. The study population was aged 65 years or older, attending an ED during the 2013/2014 financial year. We developed and internally validated a clinical prediction rule...
February 1, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28139312/impact-of-an-emergency-short-stay-unit-on-emergency-department-performance-of-poisoned-patients
#6
Michael A Downes, James K Balshaw, Tracy M Muscat, Nicole Ritchie, Geoffrey K Isbister
OBJECTIVES: This was a before and after study which sought to assess the impact of opening an ED short stay unit (ESSU) on the ED performance of poisoned patients. METHODS: Data was collected from two groups of adult patients presenting to an ED with a tertiary referral inpatient Toxicology unit from the 2009 and 2012 calendar years, to assess the impact of the ESSU. The toxicology unit clinical database and hospital electronic medical records were interrogated for demographic, clinical and hospital flow details of presentations...
January 26, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28108139/emergency-department-waiting-room-nurse-role-a-key-informant-perspective
#7
Kelli Innes, Debra Jackson, Virginia Plummer, Doug Elliott
BACKGROUND: Emergency departments have become overcrowded with increased waiting times. Strategies to decrease waiting times include time-based key performance indicators and introduction of a waiting room nurse role. The aim of the waiting room nurse role is to expedite care by assessing and managing patients in the waiting room. There is limited literature examining this role. METHODS: This paper presents results of semi-structured interviews with five key informants to explore why and how the waiting room nurse role was implemented in Australian emergency departments...
February 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28065392/mapping-the-process-of-emergency-care-at-a-teaching-hospital-in-ghana
#8
Emily Aaronson, Elizabeth Mort, Samara Soghoian
Emergency Department (ED) overcrowding has become a global concern as the number of countries with formalized emergency care systems has expanded, and the burden of trauma and non-communicable diseases in low and middle-income countries increased. In light of this, the international Emergency Medicine literature has outlined the need for operational projects in low and middle income countries which focus on the process of care. Despite this, there is limited published literature describing these types of projects...
January 3, 2017: Healthcare
https://www.readbyqxmd.com/read/27973563/frequent-use-of-emergency-departments-by-the-elderly-population-when-continuing-care-is-not-well-established
#9
Jacopo M Legramante, Laura Morciano, Francesca Lucaroni, Francesco Gilardi, Emanuele Caredda, Alessia Pesaresi, Massimo Coscia, Stefano Orlando, Antonella Brandi, Germano Giovagnoli, Vito N Di Lecce, Giuseppe Visconti, Leonardo Palombi
INTRODUCTION: The elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with "elderly frequent users"...
2016: PloS One
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
#10
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
#11
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...
January 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27836151/violence-in-the-emergency-department
#12
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
#13
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
#14
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
#15
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/27765045/individual-predictors-of-frequent-emergency-department-use-a-scoping-review
#16
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/27687168/effect-of-a-multi-diagnosis-observation-unit-on-emergency-department-length-of-stay-and-inpatient-admission-rate-at-two%C3%A2-canadian-hospitals
#17
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
#18
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/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
#19
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...
November 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
#20
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)...
January 2017: La Revue de Médecine Interne
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