CJEM
-
Pressures related to the COVID-19 pandemic have created the need to develop innovative ways to deliver mental health care, especially for urgent needs. After the launch of a pediatric Emergency Department (ED) Virtual Care service, we aimed to evaluate pediatric ED physicians' experiences with the use of ED virtual care for mental health assessments. ⋯ While many physicians agreed that there is a potential benefit of the ED virtual care platform for urgent mental health assessments, time constraints and lack of confidence in providing satisfactory virtual mental health care with minimal mental health support limited its acceptability. These findings can inform the future implementation of mental health services using an innovative virtual ED platform.
-
Multicenter Study
Agreement and prognostic accuracy of three ED vulnerability screeners: findings from a prospective multi-site cohort study.
To evaluate the agreement between three emergency department (ED) vulnerability screeners, including the InterRAI ED Screener, ER2, and PRISMA-7. Our secondary objective was to evaluate the discriminative accuracy of screeners in predicting discharge home and extended ED lengths-of-stay (> 24 h). ⋯ ED vulnerability scores from the three instruments had a fair agreement and were associated with important patient outcomes. The interRAI ED Screener best identifies older ED patients at greatest risk, while the PRISMA-7 and ER2 are more sensitive instruments.
-
Access to emergency medical care in Ontario has been under stress, mainly due to a lack of human resources (staffing of nurses and doctors). Over the past year, several emergency departments in Ontario have closed. Some of these closures are nightly, while others have closed for weeks at a time, leaving Ontario residents without access to emergency medical care which can lead to poor or more severe outcomes. The purpose of this paper was to examine how closures of ED's in Ontario have influenced potential access to emergency medical care. ⋯ ED closures have led to decreases in potential access to emergency care for predominantly rural populations. Health human resource recovery strategies must focus on areas where lack of overlap exists.