Articles: emergency-medicine.
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Multicenter Study
UK multisite evaluation of the impact of clinical educators in EDs from a learner's perspective.
In England, demand for emergency care is increasing while there is also a staffing shortage. The Royal College of Emergency Medicine (RCEM) suggested that appointment of senior doctors as clinical educators (CEs) would enable support and development of learners in EDs and improve retention and well-being. This study aimed to evaluate the impact of CEs in ED on learners. ⋯ According to survey respondents, deployment of CEs across NHS Trusts has resulted in improvement and increased accessibility of learning and assessment opportunities for learners within ED. The impact of CEs on well-being is uncertain with half reporting improvement and the remaining half unsure. Further evaluation within the project will continue to explore the service benefit and workforce impact of the CEED intervention.
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Multicenter Study
Association between patient-physician gender concordance and patient experience scores. Is there gender bias?
Patient satisfaction, a commonly measured indicator of quality of care and patient experience, is often used in physician performance reviews and promotion decisions. Patient satisfaction surveys may introduce gender-related bias. ⋯ Female patients prefer female emergency physicians but were less satisfied with their physician and emergency department visit overall. Over-representation of female patients on patient satisfaction surveys introduces bias. Patient satisfaction surveys should be deemphasized from physician compensation and promotion decisions.
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Multicenter Study
Discharge in Pandemic: Suspected Covid-19 patients returning to the Emergency Department within 72 hours for admission.
Coronavirus disease 2019 (Covid-19) has led to unprecedented healthcare demand. This study seeks to characterize Emergency Department (ED) discharges suspected of Covid-19 that are admitted within 72 h. ⋯ Several factors emerge as associated with 72-h ED return admission in subjects suspected of Covid-19. These should be considered when assessing discharge risk in clinical practice.
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The occurrence of head computed tomography (HCT) at emergency department (ED) visit for non-specific neurological symptoms has been associated with increased subsequent stroke risk and may be a marker of diagnostic error. We evaluate whether HCT occurrence among ED headache patients is associated with increased subsequent cerebrovascular disease risk. ⋯ Having a HCT performed at ED treat-and-release headache visit is associated with increased risk of subsequent cerebrovascular disease. Future work to improve cerebrovascular disease prevention strategies in this subset of headache patients is warranted.
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Multicenter Study
Acuity patterns of heart failure among emergency departments in a large health system.
The prognostic importance of Emergency Heart Failure Mortality Risk Grade (EHMRG) score in assessing short term mortality in Congestive Heart Failure (CHF) patients has been validated in the past, however, few studies have examined acuity patterns in the CHF population across healthcare settings. We aim to understand acuity patterns of CHF patients across a large health system for better resource utilization. ⋯ Academic hospitals had a higher number of Acute Heart Failure (AHF) patients, larger number of low acuity patients, higher admission rates, but less revisit rates to the ED as compared to community hospitals. We suggest acuity specific interventions will help decrease admission and revisit rates.