Healthcare quarterly (Toronto, Ont.)
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The dramatic rise in prescription opioid use in the past two decades across Canada and the United States has been accompanied by increased rates of adverse events, including premature death and neonatal abstinence syndrome. In Ontario, policies and programs designed to address inappropriate prescribing have been implemented with varying degrees of success. Emerging issues that require ongoing attention include the introduction of abuse-deterrent formulations of opioids and generic versions of long-acting oxycodone. As issues related to opioid misuse, abuse and premature overdose death continue to evolve, it is clear that they can only be addressed by more cautious prescribing practices and the provision of support to those already suffering from addiction.
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Emergency departments (ED) function to diagnose, stabilize, manage and dispose patients as efficiently as possible. Although problems may be suspected at triage, ED physician input is required at each step of the patient journey through the ED, from diagnosis to disposition. ⋯ This article discusses the key concepts of ED patient flow, value and efficiency. Based on these fundamentals, it describes the significant impact of ED process improvements implemented on measures of ED efficiency at a large community ED in Ontario, Canada.