J Emerg Med
-
Emergency physicians make treatment decisions in patients who present to the emergency department (ED) with acute venous thromboembolism (VTE). They also encounter patients on target-specific oral anticoagulants (TSOACs) who require urgent intervention. New approvals and increasing prescriptions for TSOACs (e.g., apixaban, dabigatran, edoxaban, and rivaroxaban) for the management of several thromboembolic disorders warrant an evaluation of the impact of these agents in the ED setting. ⋯ Familiarity with TSOACs will better position emergency physicians to provide state-of-the art care to their patients with VTE and help them manage potentially complicated circumstances related to the chronic use of these drugs.
-
Comparative Study
Emergency Department Expansion Versus Patient Flow Improvement: Impact on Patient Experience of Care.
Most strategies used to help improve the patient experience of care and ease emergency department (ED) crowding and diversion require additional space and personnel resources, major process improvement interventions, or a combination of both. ⋯ Our results demonstrate that the impact of process improvement and rapid assessment implementation is far greater than the impact of renovation and facility expansion.
-
Rising health care costs and increased scrutiny concerning spending have prompted providers and hospitals to identify unnecessary procedures and waste. Peripheral intravenous line (pIV) placement is one of the most common medical procedures performed. A recent study reported that 50% of intravenous lines placed in the emergency department (ED) went unused. If half of all pIVs placed in EDs systemically go unused, the costs and complications associated with pIV placement are unacceptably high. ⋯ In this study's ED, 85% of pIVs were used prior to discharge. Strategies to lower pIV placement rates should focus on alternative routes of medication and fluid administration.