Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Customer satisfaction measurement in emergency medical services.
The annual patient volume in emergency medical services (EMS) systems is high worldwide. However, there are no comprehensive studies on customer satisfaction for EMS. The authors report how a customer satisfaction survey on EMS patients was conducted, the results, and the possible causes for dissatisfaction. ⋯ This study shows that customer satisfaction surveys can be successfully conducted for EMS. EMS systems should consider routinely using customer satisfaction surveys as a tool for quality measurement and improvement.
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This study evaluated a sample of emergency department (ED) patients for history of violence and substance abuse. ⋯ A large percentage of injured patients in this urban ED experienced violence in the past year. Alcohol and illicit drugs appear to be concomitant with violence.
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Comparative Study
The effect of a new emergency medicine residency program on patient length of stay in a community hospital emergency department.
It is not clear how emergency medicine residents affect emergency department (ED) efficiency. The objective of this study was to determine whether a new emergency medicine residency program affected the length of stay (LOS) of patients in a community hospital ED. ⋯ In this ED, there was a weak, positive correlation between ED patient length of stay and the presence of PGY-3 emergency medicine residents.
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The performance of out-of-hospital systems is frequently evaluated based on the times taken to respond to emergency requests and to transport patients to hospital. The 90th percentile is a common statistic used to measure these indicators, since they reflect performance for most patients. Traditional regression models, which assess how the mean of a distribution varies with changes in patient or system characteristics, are thus of limited use to researchers in out-of-hospital care. ⋯ In other words, ambulance diversion disproportionately affects those patients who already have longer transport intervals. Second, the distribution of transport intervals, conditional on a given set of variables, is positively skewed, and not uniformly or symmetrically distributed. The flexibility of quantile regression models makes them particularly well suited to out-of-hospital research, and they may allow for more relevant evaluation of out-of-hospital system performance.
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A national survey of emergency medicine (EM) residency program directors (PDs) was conducted to review training and evaluation of residents in electrocardiogram (ECG) interpretation and to assess the attitudes of PDs toward establishing national criteria for ECG competency. ⋯ While a majority of EM residency programs surveyed have a formal curriculum for ECG interpretation, less than a fourth formally test their residents or require proof of competency. The majority of residency PDs oppose the development of a national ECG examination or competency requirement for graduation. Implementation of the Accreditation Council for Graduate Medical Education directive for the demonstration of clinical competencies will be challenging given the current position of PDs.