Articles: hospital-emergency-service.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effectiveness of an organized emergency department follow-up system.
Half the patients discharged home from our emergency department with the diagnoses of acute infection, cervicolumbar strain, bronchospasm, allergic reaction, headache, syncope, vaginal hemorrhage, and undiagnosed chest/abdominal pain were randomly assigned to receive a follow-up telephone call two to three days after their visit. Patients in the follow-up call group were telephoned by an ED nurse who questioned them about changes in their clinical status and clarified the aftercare and referral instructions received during the ED visit. Seven days after the visit, a questionnaire that rated patient satisfaction about six aspects of the ED visit was sent to those patients who had been contacted successfully (study group), and to a diagnosis-matched group of patients (control) who did not receive a follow-up call. ⋯ No difference was observed in questionnaire ratings between the female study and control groups. We conclude that male patients reached by a follow-up telephone call have a more positive perception of their ED visit. A follow-up call also can be useful for reinforcing aftercare instructions, follow-up referrals, and problem-patient identification.
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The Committee on Trauma of the American College of Surgeons published a report in 1976 charging hospitals to provide care for seriously injured patients. Implementing an effective emergency care/trauma system in a not-for-profit community hospital was a task that demanded leadership, substantial time, and commitment. The building process could not have begun without a strong commitment from the hospital's board, administration, medical staff, and nursing service. ⋯ Monthly in-service programs were begun for the intensive care unit (ICU) and ED nurses. In each of the past 3 years, a 2-day trauma update program has been provided to the regional Emergency Medical Services (EMS) and medical community. The dedication and commitment of many people during the past 5 years has resulted in a sound system of emergency/trauma care in a community hospital.
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Computer-aided teaching in the emergency department offers an important adjunct to traditional lectures and bedside clinical teaching. Using an integrated software system, lessons and patient simulations were created for the emergency department. ⋯ Acceptance and usage rates are high and remain so even after the initial novelty of the system declined. To be useful, such a system should be accessible over extended hours, and lessons should be brief and simple to execute.