Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Improving physician compliance with evidence-based guidelines is challenging. The authors wanted to determine if weekly e-mail reminders to emergency department (ED) staff increase compliance with Joint Commission and the Centers for Medicare and Medicaid Services (CMS) community-acquired pneumonia quality measures. ⋯ Weekly e-mail reminders listing performance on antibiotic administration recommendations are associated with increased compliance with a clinical guideline.
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Emergency departments (EDs) are traditionally designed to provide rapid evaluation and stabilization and are neither staffed nor equipped to provide prolonged care. Longer ED length of stay (LOS) may compromise quality of care and contribute to delays in the emergency evaluation of other patients. ⋯ Emergency department LOS in the United States is increasing, especially for critically ill patients for whom time-sensitive interventions are most important. The disparity of longer ED LOS for African Americans and Hispanics is not improving.
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In this article we present a summary of two interactive panel discussions held at the 2008 Council of Emergency Medicine Residency Directors (CORD) annual meeting. Attendees attempted to identify measurable outcomes for resident performance that could be used to evaluate program effectiveness.
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Randomized Controlled Trial
Dating aggression and risk behaviors among teenage girls seeking gynecologic care.
The objective was to describe rates of dating aggression and related high-risk behavior among teens presenting to the emergency department (ED) seeking gynecologic care, compared to those seeking care for other reasons. ⋯ Of the teens undergoing gynecologic evaluation in this urban ED, 49% reported dating aggression. These teens also reported higher rates of other sexual risk behaviors compared to their peers. Care providers in urban EDs treating all female teens and particularly those seeking gynecologic care should be aware of this high rate of dating aggression and screen for aggression in dating relationships in this high-risk group.
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Multicenter Study
Emergency department patient flow: the influence of hospital census variables on emergency department length of stay.
The objective was to evaluate the association between hospital census variables and emergency department (ED) length of stay (LOS). This may give insights into future strategies to relieve ED crowding. ⋯ In multiple hospital settings, ED LOS is correlated with the number of admissions and census of the higher acuity nursing units, more so than the number of ED patients each day, particularly in larger hospitals with busier EDs. Streamlining ED admissions and improving availability of inpatient critical care beds may reduce ED LOS.