Articles: emergency-department.
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Emerg Med Australas · Dec 2022
Structured evaluation of a virtual emergency department triage model of care: A study protocol.
A new virtual ED service was introduced into a hospital network in the northern suburbs of Melbourne in response to changing needs during the COVID-19 pandemic. The 'virtual ED' utilises a telehealth model as a means of assessment for appropriately selected patients to facilitate either complete care or navigation into streamlined pathways for ongoing care, in some cases bypassing the ED entirely where appropriate. The proposed study aims to evaluate the implementation of the model and identify future improvement opportunities, assess the impact on traditional health service delivery processes and patient experience, and determine the acceptability of the 'virtual ED' model of care. ⋯ This project will support the delivery of care to ED patients by evaluating the 'virtual ED' model of care.
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Pediatric emergency care · Dec 2022
Redirecting Nonurgent Patients From the Pediatric Emergency Department to Their Pediatrician Office for a Same-Day Visit-A Quality Improvement Initiative.
Providing high-quality care in the appropriate setting to optimize value is a worthy goal of an efficient health system. Consequences of managing nonurgent complaints in the emergency department (ED) have been described including inefficiency, loss of the primary care-patient relationship, and delayed care for other ED patients. The purpose of this initiative was to redirect nonurgent patients arriving in the ED to their primary care office for a same-day visit, and the SMART AIM was to increase redirected patients from 0% of those eligible to 30% in a 12-month period. ⋯ This initiative redirected nonurgent patients efficiently from a PED setting to their primary care office. The process is beneficial to patients and families and supports the patient-centered medical home. The balancing measure of no harm done to patients who accepted redirect reinforced the reliability of PED triage. The benefits achieved through the project highlight the value of the primary care-patient relationship and the continued need to improve access for patients and families.
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Housing insecurity is prevalent among emergency department (ED) patients. Despite a surge of interest in screening for patients' social needs including housing insecurity, little research has examined ED social needs interventions. We worked together with government and community partners to develop and pilot test a homelessness prevention intervention targeted to ED patients with drug or unhealthy alcohol use. ⋯ This pilot intervention was feasible and well received by participants though it required a large amount of screening to identify potentially eligible patients. Our findings will inform a larger future trial and may be informative for others seeking to develop similar interventions.
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Risk stratification is increasingly based on Early Warning Score (EWS)-based models, instead of clinical judgement. However, it is unknown how risk-stratification models and EWS perform as compared with the clinical judgement of treating acute healthcare providers. Therefore, we performed a systematic review of all available literature evaluating clinical judgement of healthcare providers to the use of risk-stratification models in predicting patients' clinical outcome. ⋯ CRD42020218893.
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Eur J Trauma Emerg Surg · Dec 2022
Ways to improve guideline adherence in the emergency department: an interview study on the management of traumatic brain injuries.
The aim was to explore factors affecting guideline adherence among doctors in the emergency department and to explore the general perception about local guidelines for traumatic brain injuries. ⋯ The participants believed that guideline adherence would increase by facilitating guideline availability, by providing concise, easy-to-understand, and well-illustrated guidelines available in printed form, as well as establishing a culture that promotes guideline use. The local guidelines for traumatic brain injuries were appreciated, but could be improved.