Articles: emergency-services.
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Annals of family medicine · Nov 2024
Comparative StudyHealth Care Utilization After a Visit to a Within-Group Family Physician vs a Walk-In Clinic Physician.
Primary care access is a key health system metric, but little research has compared models to provide primary care access when one's regular physician is not available. We compared health system use after a visit with a patient's own family physician group (ie, within-group physician who was not the patient's primary physician) vs a visit with a walk-in clinic physician who was not part of the patient's family physician group. ⋯ Compared to visiting a walk-in clinic physician, seeing a within-group physician after hours might decrease downstream emergency department visits. This finding could be explained by better continuity of care and can inform primary care service models and the policies that support them.
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Annals of family medicine · Nov 2024
Development of an Emergency Department Surge Plan Based on the NEDOCS score.
Context: Emergency Department (ED) overcrowding is a significant problem worldwide. Many factors contribute to ED overcrowding, including staffing shortages, diagnostic testing delays, and inadequate inpatient beds to meet the demand. ED overcrowding results in patient safety issues like higher inpatient mortality and other negative impacts, such as an increased length of stay (LOS) and an increased trend of leaving the ED before undergoing an evaluation and treatment. ⋯ Conclusions: Our study suggests that implementing an ED adult surge plan can significantly improve ED hold hours and NEDOCS scores. However, it is important to note that other important ED throughput metrics (mean ED LOS, left without seen rate, mean door-to-doctor exam time) did not significantly improve. Further research may be necessary to understand the factors contributing to these outcomes and identify additional interventions that may improve ED throughput.
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Postgraduate medicine · Nov 2024
Comparative StudyExploring the potential of artificial intelligence models for triage in the emergency department.
To perform a comparative analysis of the three-level triage protocol conducted by triage nurses and emergency medicine doctors with the use of ChatGPT, Gemini, and Pi, which are recognized artificial intelligence (AI) models widely used in the daily life. ⋯ The undertriage rates observed in AI models were considerably high. Hence, it does not yet seem appropriate to solely rely on the specified AI models for triage purposes in the emergency department.
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Observational Study
Evaluation of use and identification of predictive factors for nonuse of peripheral venous catheters in the emergency department.
The placement of peripheral venous catheters (PVC) is a frequent procedure in the emergency department (ED), which exposes patients to complications (hematoma, fluid leakage, phlebitis, edema, infection), increases hemolysis of blood samples, is time-consuming and costly. The main aim of this study is to analyze the rate of PVC nonuse in the ED and to identify predictive factors of their nonuse. This prospective single-center observational study was conducted in the ED of the Saint-Antoine Hospital in Paris, France between February and March 2022. ⋯ PVC were not used in 23.7% of cases. Predictors of nonuse were the prescribing physician's expectation of nonuse and the reason for prescribing "just in case". A PVC should probably not be prescribed if the prescribing physician thinks it will not be used or prescribes it "just in case".
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The aim of this study is to evaluate gender perception among patients in the emergency department (ED) and to examine the effect of gender perception on patients' preference of physician's gender. ⋯ In the context of emergency settings and general examinations, approximately three-quarters of the participants indicated no preference regarding the gender of the physician. However, in the case of sensitive medical issues, the proportion of participants with no gender preference was less than half. For patients with a gender preference for their physician, perception of gender is a significant predictor.