Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Studies in emergency department data collection: shared versus split responsibility for patient enrollment.
To compare patient enrollment in six clinical studies using shared coverage (24 emergency department [ED] rooms-two students share enrollment responsibility) with enrollment using split coverage (12 rooms each per student). The academic associate (AA) program uses undergraduate students to collect data for clinical studies in the ED by providing double coverage 16 hours/day, seven days/week. Prior studies have shown that this system captures >85% of eligible patients. Methods to obtain closer to 100% enrollment are desired. ⋯ Study subject enrollment was not affected by the use of either the shared or split responsibility strategy for recruitment. Students generally preferred the split strategy because it was more helpful and easier to monitor. Therefore, this may be the best option for similar student-oriented data collection programs.
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Comparative Study
Utilization of the emergency department after self-inflicted injury.
To compare emergency department (ED) utilization by individuals who present with self-inflicted injuries with utilization by control populations. Individuals with self-inflicted injuries commonly present to the ED, yet little research has been conducted on this population in this setting. ⋯ Individuals who harm themselves are chronic users of the ED. The ED represents an opportune setting from which individuals can be directed to appropriate treatment programs.
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Comparative Study
An evaluation of emergency medicine resident interaction time with faculty in different teaching venues.
To measure actual emergency medicine (EM) resident interaction time with faculty and to investigate the potential to use direct observation as an assessment tool for the core competencies. By 2006 all EM residencies must implement resident assessment techniques of the six Accreditation Council for Graduate Medical Education core competencies. Emergency medicine educators recommend direct observation as the optimal evaluation tool for patient care, systems-based practice, interpersonal and communication skills, and professionalism. Continuous faculty presence in the emergency department (ED) is widely believed to facilitate direct observation as an assessment technique. ⋯ Faculty direct observation time of EM residents was low in all training venues studied. Direct observation was the highest in ED critical care areas and lowest on medicine ward rotations. Emergency medicine faculty involved simultaneously in routine ED teaching, supervision, and patient care rarely performed direct observation, despite their continuous physical presence. This finding suggests that alternative strategies may be required to assess core competencies through direct observation in the ED.
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Comparative Study
Emergency department patient satisfaction: examining the role of acuity.
To explore the relationships between patient acuity, perceived and actual throughput times, and emergency department (ED) patient satisfaction. The authors hypothesized that high-acuity patients would be the most satisfied with their throughput times, as well as the overall ED visit. The authors also expected overall ED satisfaction to be more strongly associated with perceived throughput times compared with actual throughput times, regardless of acuity. ⋯ "Emergent" patients are more satisfied than "urgent" and "routine" patients with their ED visits. "Emergent" patients perceived their throughput times more favorably than other patients, especially their wait for physician evaluation. Changing perceptions of throughput times may yield larger improvements in satisfaction than decreasing actual throughput times, regardless of patient acuity.
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To determine the length of catheter required to perform a needle thoracostomy, as determined by chest wall thickness, to treat the majority of patients presenting to the emergency department (ED) with a potential tension pneumothorax. ⋯ In this study, a catheter length of 5 cm would reliably penetrate the pleural space of only 75% of patients. A longer catheter should be considered, especially in women.