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Clinical risks around planning care pathways for ED patients.

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By Arthur Cronwright Aspiring to best practice always
P A Cameron, B J Gabbe, K Smith, B Mitra
Trauma systems have been successful in saving lives and preventing disability. Making sure that the right patient gets the right treatment in the shortest possible time is integral to this success. Most trauma systems have not fully developed trauma triage to optimize outcomes. For trauma triage to be effective, there must be a well-developed pre-hospital system with an efficient dispatch system and adequately resourced ambulance system. Hospitals must have clear designations of the level of service provided and agreed protocols for reception of patients...
August 2014: British Journal of Anaesthesia
Jin Hee Jeong, Seung Sik Hwang, Kyuseok Kim, Jin Hee Lee, Joong Eui Rhee, Changwoo Kang, Soo Hoon Lee, Hooyoung Kim, Yeon Sook Im, Boeknam Lee, Young Im Byeon, Ji Sook Lee
OBJECTIVE: Return visits to the paediatric emergency department (PED) are an important measure of quality of healthcare and are associated with patients' and parents'/guardians' satisfaction. Previous studies have been limited to describing characteristics and factors related to return visits. The objectives of this study were to develop new clinical practices to reduce return visits to the PED and to see whether implementation of these practices had the desired effect. PATIENTS AND METHODS: This was a controlled before-and-after study...
June 2015: Emergency Medicine Journal: EMJ
Daniel C Payne, Jan Vinjé, Peter G Szilagyi, Kathryn M Edwards, Mary Allen Staat, Geoffrey A Weinberg, Caroline B Hall, James Chappell, David I Bernstein, Aaron T Curns, Mary Wikswo, S Hannah Shirley, Aron J Hall, Benjamin Lopman, Umesh D Parashar
BACKGROUND: Cases of rotavirus-associated acute gastroenteritis have declined since the introduction of rotavirus vaccines, but the burden of norovirus-associated acute gastroenteritis in children remains to be assessed. METHODS: We conducted active surveillance for laboratory-confirmed cases of norovirus among children younger than 5 years of age with acute gastroenteritis in hospitals, emergency departments, and outpatient clinical settings. The children resided in one of three U...
March 21, 2013: New England Journal of Medicine
Chad G Ball
A highly organized approach to the evaluation and treatment of penetrating torso injuries based on regional anatomy provides rapid diagnostic and therapeutic consistency. It also minimizes delays in diagnosis, missed injuries and nontherapeutic laparotomies. This review discusses an optimal sequence of structured rapid assessments that allow the clinician to rapidly proceed to gold standard therapies with a minimal risk of associated morbidity.
April 2014: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Ine Borghans, Karin D Hekkert, Lya den Ouden, Sezgin Cihangir, Jan Vesseur, Rudolf B Kool, Gert P Westert
OBJECTIVES: We developed an outcome indicator based on the finding that complications often prolong the patient's hospital stay. A higher percentage of patients with an unexpectedly long length of stay (UL-LOS) compared to the national average may indicate shortcomings in patient safety. We explored the utility of the UL-LOS indicator. SETTING: We used data of 61 Dutch hospitals. In total these hospitals had 1 400 000 clinical discharges in 2011. PARTICIPANTS: The indicator is based on the percentage of patients with a prolonged length of stay of more than 50% of the expected length of stay and calculated among survivors...
2014: BMJ Open
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