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https://www.readbyqxmd.com/read/28504772/patient-flow-in-acute-medical-units-a-design-approach-to-flow-improvement
#1
L de Almeida, E Matthews
No abstract text is available yet for this article.
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28494806/what-makes-weekend-allied-health-services-effective-and-cost-effective-or-not-in-acute-medical-and-surgical-wards-perceptions-of-medical-nursing-and-allied-health-workers
#2
Lisa O'Brien, Deb Mitchell, Elizabeth H Skinner, Romi Haas, Marcelle Ghaly, Fiona McDermott, Kerry May, Terry Haines
BACKGROUND: There is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment. This study aimed to identify factors that might enable an effective and cost-effective weekend allied health services on acute hospital wards. METHODS: This qualitative study included 22 focus groups within acute wards with a weekend allied health service and 11 telephone interviews with weekend service providers...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28494481/enhanced-hip-fracture-management-use-of-statistical-methods-and-dataset-to-evaluate-a-fractured-neck-of-femur-fast-track-pathway-pilot-study
#3
Nigel Gilchrist, Kristian Dalzell, Scott Pearson, Gary Hooper, Kit Hoeben, Jeremy Hickling, John McKie, Ma Yi, Sandra Chamberlain, Caroline McCullough, Marc Gutenstein
The increasing elderly population and subsequent rise in total hip fracture(s) in this group means more effective management strategies are necessary to improve efficiency. We have changed our patient care strategy from the emergency department (ED), acute orthopaedic wards, operating theatre, post-operation and rehabilitation, and called it Fracture Neck of Femur Fast Track Pathway. All clinical data and actions were captured, integrated and displayed on a weekly basis using 'signalfromnoise' (SFN) software...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28487459/patient-flow-within-uk-emergency-departments-a-systematic-review-of-the-use-of-computer-simulation-modelling-methods
#4
Syed Mohiuddin, John Busby, Jelena Savović, Alison Richards, Kate Northstone, William Hollingworth, Jenny L Donovan, Christos Vasilakis
OBJECTIVES: Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28485885/hospital-occupancy-and-discharge-strategies-a-simulation-based-study
#5
S Qin, C Thompson, T Bogomolov, D Ward, P Hakendorf
BACKGROUND: Increasing demand for hospital services has resulted in more arrivals to emergency department (ED), increased admissions, and, quite often, access block and ED congestion, along with patients' dissatisfaction. Cost constraints limit an increase in the number of hospital beds, so alternative solutions need to be explored. AIMS: The aims of this study were to propose and test different discharge strategies which, potentially, could reduce occupancy rates in the hospital, thereby improving patient flow and minimising frequency and duration of congestion episodes...
May 9, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28485255/a-system-based-intervention-to-improve-access-to-hyperacute-stroke-care
#6
Richard H Swartz, Elizabeth Linkewich, Shelley Sharp, Jacqueline Willems, Chris Olynyk, Nicola Tahair, Megan L Cayley, Mark T Bayley
BACKGROUND: Hyperacute stroke is a time-sensitive emergency for which outcomes improve with faster treatment. When stroke systems are accessed via emergency medical services (EMS), patients are routed to hyperacute stroke centres and are treated faster. But over a third of patients with strokes do not come to the hospital by EMS, and may inadvertently arrive at centres that do not provide acute stroke services. We developed and studied the impact of protocols to quickly identify and move "walk-in" patients from non-hyperacute hospitals to regional stroke centres (RSCs)...
May 9, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28484942/minimal-training-sufficient-to-diagnose-pediatric-wrist-fractures-with-ultrasound
#7
Henrik Hedelin, Christian Tingström, Hanna Hebelka, Jon Karlsson
BACKGROUND: In children, non-fractured wrists generally need no treatment and those that are fractured may only require a 3-week cast without any clinical follow-up. The ability to perform a point-of-care triage decision if radiographs are needed could improve patient flow and decrease unnecessary radiographs. The aim of this study was to evaluate the role of ultrasound (US) as a point-of-care triage tool for pediatric wrist injuries with limited training. METHODS: Physicians with no previous US experience attended a 1...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28483035/management-of-patients-brought-in-by-ambulance-to-the-emergency-department-role-of-the-advanced-musculoskeletal-physiotherapist
#8
Rita Kinsella, Tom Collins, Bridget Shaw, James Sayer, Belinda Cary, Andrew Walby, Sallie Cowan
Objective The aim of the present study was to evaluate the role of the Advanced Musculoskeletal Physiotherapist (AMP) in managing patients brought in by ambulance to the emergency department (ED).Methods This study was a dual-centre observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12-month period and seen by an AMP were compared with a matched group seen by other ED staff. Primary outcome measures were wait time and length of stay (LOS) in the ED.Results Data from 1441 patients within the Australasian Triage Scale (ATS) Categories 3-5 with musculoskeletal complaints were included in the analysis...
May 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28472233/the-potential-for-interventions-in-a-long-term-acute-care-hospital-to-reduce-transmission-of-carbapenem-resistant-enterobacteriaceae-in-affiliated-healthcare-facilities
#9
Damon J A Toth, Karim Khader, Rachel B Slayton, Alexander J Kallen, Adi V Gundlapalli, Justin J O'Hagan, Anthony E Fiore, Michael A Rubin, John A Jernigan, Matthew H Samore
Background.: Carbapenem-resistant Enterobacteriaceae (CRE) are high-priority bacterial pathogens targeted for efforts to decrease transmissions and infections in healthcare facilities. Some regions have experienced CRE outbreaks that were likely amplified by frequent transmission in long-term acute care hospitals (LTACHs). Planning and funding intervention efforts focused on LTACHs is one proposed strategy to contain outbreaks; however, the potential regional benefits of such efforts are unclear...
May 3, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28471694/toward-implementing-patient-flow-in-a-cancer-treatment-center-to-reduce-patient-waiting-time-and-improve-efficiency
#10
Samuel Suss, Nadia Bhuiyan, Kudret Demirli, Gerald Batist
Outpatient cancer treatment centers can be considered as complex systems in which several types of medical professionals and administrative staff must coordinate their work to achieve the overall goals of providing quality patient care within budgetary constraints. In this article, we use analytical methods that have been successfully employed for other complex systems to show how a clinic can simultaneously reduce patient waiting times and non-value added staff work in a process that has a series of steps, more than one of which involves a scarce resource...
May 4, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28423982/from-data-to-improved-decisions-operations-research-in-healthcare-delivery
#11
Muge Capan, Anahita Khojandi, Brian T Denton, Kimberly D Williams, Turgay Ayer, Jagpreet Chhatwal, Murat Kurt, Jennifer Mason Lobo, Mark S Roberts, Greg Zaric, Shengfan Zhang, J Sanford Schwartz
BACKGROUND: The Operations Research Interest Group (ORIG) within the Society of Medical Decision Making (SMDM) is a multidisciplinary interest group of professionals that specializes in taking an analytical approach to medical decision making and healthcare delivery. ORIG is interested in leveraging mathematical methods associated with the field of Operations Research (OR) to obtain data-driven solutions to complex healthcare problems and encourage collaborations across disciplines. This paper introduces OR for the non-expert and draws attention to opportunities where OR can be utilized to facilitate solutions to healthcare problems...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28419793/impact-of-emergency-department-discharge-stream-short-stay-unit-performance-and-hospital-bed-occupancy-rates-on-access-and-patient-flowmeasures-a-single-site-study
#12
Amith L Shetty, Caleb Teh, Matthew Vukasovic, Shannon Joyce, Milan R Vaghasiya, Roberto Forero
OBJECTIVE: The ED discharge stream short stay units (EDSSUs) aim to facilitate patient flows through EDs. We investigate the relationship between EDSSU census and hospital bed occupancy rates (BORs) on National Emergency Access Target (NEAT) performance and did-not-wait (DNW) rates at a tertiary metropolitan adult ED in Sydney, Australia. METHODS: We collated data for all ED presentations between 1 January 2012 and 31 December 2014. Daily ED, EDSSU census and ED-accessible hospital BORs were tabulated with daily ED NEAT performance and DNW rates...
April 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28413420/overcrowding-in-emergency-departments-a-review-of-strategies-to-decrease-future-challenges
#13
REVIEW
Mohammad H Yarmohammadian, Fatemeh Rezaei, Abbas Haghshenas, Nahid Tavakoli
Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study is to present strategies that have proven to reduce delay and overcrowding in EDs. In this review article, initial electronic database search resulted in a total of 1006 articles. Thirty articles were included after reviewing full texts. Inclusion criteria were assessments of real patient flows and implementing strategies inside the hospitals. In this study, we discussed strategies of team triage, point-of-care testing, ideal ED patient journey models, streaming, and fast track...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28401682/guideline-based-intervention-to-reduce-telemetry-rates-in-a-large-tertiary-centre
#14
Satish Ramkumar, Edward H Tsoi, Ajay Raghunath, Floyd F Dias, Christopher Li Wai Suen, Andrew H Tsoi, Darren R Mansfield
BACKGROUND: Inappropriate cardiac telemetry use is associated with reduced patient flow and increased health care costs. AIM: To evaluate the outcomes of guideline-based application of cardiac telemetry. METHODS: Phase I involved a prospective audit(03-09/2011) of telemetry use at a tertiary hospital. Data was collected on indication for telemetry and clinical outcomes. Phase II prospectively included patients > 18yrs under general medicine requiring ward based telemetry...
April 12, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28400902/a-novel-neuroscience-intermediate-level-care-unit-model-retrospective-analysis-of-impact-on-patient-flow-and-safety
#15
Alexandra E Quimby, Michel C F Shamy, Deanna M Rothwell, Erin Y Liu, Dar Dowlatshahi, Grant Stotts
BACKGROUND AND PURPOSE: Neurointensive care units have been shown to improve patient outcomes across a variety of neurological and neurosurgical conditions. However, the efficacy of less resource-intensive intermediate-level care units to deliver similar care has not been well studied. The purpose of this study is to evaluate the impact of neurocritical specialist comanagement on patient flow and safety in a neuroscience intermediate-level care unit. METHODS: Our intervention consisted of the addition of a physician with critical care experience as well as training in neurology, anesthesiology, or intensive care to a neuroscience intermediate-level care unit to comanage patients alongside neurology and neurosurgery staff during weekday daytime hours...
April 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28387619/implementation-of-interdisciplinary-neurosurgery-morning-huddle-cost-effectiveness-and-increased-patient-satisfaction
#16
Alvin Y Chan, Sumeet Vadera
OBJECTIVE Morning discharge huddles consist of multiple members of the inpatient care team and are used to improve communication and patient care and to facilitate patient flow through the hospital. However, the effect of huddles on hospital costs and patient satisfaction has not been clearly elucidated. The authors investigated how a neurosurgeryled interdisciplinary daily morning huddle affected various costs of patient care and patient satisfaction. METHODS Huddles were conducted at 8:30 am Monday through Friday, and lasted approximately 30 minutes...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28382638/intra-hospital-transfers-and-the-impact-on-nursing-workload
#17
Nicole Blay, Michael Roche, Christine Duffield, Robyn Gallagher
AIMS AND OBJECTIVES: To determine the rate of patient moves and the impact on nurses' time. BACKGROUND: Bed shortages and strategies designed to increase patient flow have led to a global increase in patient transfers between wards. The impact of transferring patients between wards and between beds within a ward on nurses' workload has not previously been measured. DESIGN: A two-stage sequential study. Retrospective analysis of hospital data and a prospective observational-timing study...
April 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28375958/evidence-based-practice-standard-care-for-acute-pain-management-in-adults-with-sickle-cell-disease-in-an-urgent-care-center
#18
Sunghee Kim, Ron Brathwaite, Ook Kim
BACKGROUND: Vaso-occlusive episodes (VOEs) with sickle cell disease (SCD) require opioid treatment. Despite evidence to support rapid pain management within 30 minutes, care for these patients does not consistently meet this benchmark. This quality improvement study sought to decrease the first analgesic administration time, increase patient satisfaction, and expedite patient flow. METHODS: A prospective pre-/postevaluation design was used to evaluate outcomes with patients 18 years or older with VOEs in an urgent care (UC) center after implementation of evidence-based practice standard care (EBPSC)...
April 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28372579/va-residential-substance-use-disorder-treatment-program-providers-perceptions-of-facilitators-and-barriers-to-performance-on-pre-admission-processes
#19
Laura S Ellerbe, Luisa Manfredi, Shalini Gupta, Tyler E Phelps, Thomas R Bowe, Anna D Rubinsky, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics...
April 4, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28367010/prehospital-delay-and-time-to-reperfusion-therapy-in-st-elevation-myocardial-infarction
#20
Linsha George, Lakshmi Ramamoorthy, Santhosh Satheesh, Rama Prakasha Saya, D K S Subrahmanyam
BACKGROUND: Despite efforts aimed at reducing the prehospital delay and treatment delay, a considerable proportion of patients with ST elevation myocardial infarction (STEMI) present late and receive the reperfusion therapy after unacceptably long time periods. This study aimed at finding out the patients' decision delay, prehospital delay, door-to-electrocardiography (ECG), door-to-needle, and door-to-primary percutaneous coronary intervention (PCI) times and their determinants among STEMI patients...
April 2017: Journal of Emergencies, Trauma, and Shock
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