Articles: emergency-services.
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Gen Hosp Psychiatry · Sep 1993
Case ReportsCrisis hospitalization on a psychiatric emergency service.
The availability of short-stay beds for brief admissions to a Psychiatric Emergency Service (PES) is a model that meets a variety of patient and system needs, allowing time to develop alternatives to hospitalization or gain diagnostic clarity, serving a respite function, providing a hospital setting that does not gratify dependency needs, and relieving inpatient census pressures. An eight-bed service for brief inpatient stays of up to 3 days was developed on a PES which serves a large nine-country catchment area in northeastern New York State. Admissions to this unit would otherwise have gone to a medical school teaching hospital psychiatric unit or a state psychiatric center. ⋯ The PD patients had a strong association with suicidality and some association with substance abuse, whereas the schizophrenics had more psychiatric symptomatology. PD patients were more likely to be discharged, leading us to propose a rationale for why this group may be uniquely suited to this approach. The study was replicated after a year on another sample of 51 consecutive admissions, confirming the earlier results and providing a 1-year follow-up on the program.(ABSTRACT TRUNCATED AT 250 WORDS)
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A short-stay ward attached to the accident and emergency (A&E) department has opened recently. The development of this ward is described together with its operation over a 1-year period. Head injuries were the commonest reason for admission. Only 7% of children stayed longer than anticipated or were considered inappropriate admissions.
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To analyze the effects of war on the civilian population through patterns of medical service consumption in a pediatric emergency room. ⋯ Visits during the ware were more related to emergency situations with fewer visits of the walk-in clinic type.
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This study was undertaken to identify the reasons for unscheduled return visits to an urban emergency department, particularly those relating to physician errors in diagnosis and management, and, where possible, to identify strategies to reduce unscheduled return visits. ⋯ Significant physician errors were a minor reason for reattendance at the emergency department and no specific areas of deficiency were identified. These might be further reduced by increasing the seniority and experience of staff and by the introduction of regular audit, continuing medical education and vocational training programmes. Interventions to reduce patient related unscheduled return visits might include better explanation of the role of the emergency department and better communication with patients about their illness and treatment.