Articles: emergency-services.
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The utilization of psychiatric crisis teams in urban hospitals is well documented. However, little is reported describing patients who use crisis teams in suburban general hospital emergency rooms. This is a descriptive survey of 1707 suburban patient visits. ⋯ A regression model is used to analyze the duration of service time and utilization patterns in relation to eight variables: season, month, day, shift, diagnosis, method of payment, age, and disposition. Five predictors are identified as significantly relating to the duration of the psychiatric consultation process. These predictors may enable hospital administrators and medical staff to plan and implement psychiatric emergency room care.
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Hospital pharmacists have shown clearly their benefit in patient care by intervening to improve the drug use process. In this era of cost containment, hospital administrators are likely to fund only those programs that clearly improve patient care or reduce costs. To demonstrate the impact on a hospital budget and to justify a position or service, documentation of improvement and generation of a cost-savings report is essential. This article discusses the types and methods of clinical and cost-saving interventions that are made in a busy inner city university trauma center's emergency department, and the methods by which our data are collected.
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Physician service time varies with patient service category, length of stay, and intensity of service. ⋯ Case mix of patient services affects emergency physician workload and should be considered in planning departmental staffing needs.
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From 1978 to 1991, 126 multiply-injured patients of 65 years and over were admitted to the Department of Traumatology and Emergency Surgery of the University Hospitals of Leuven. The seriousness of the injury was evaluated using the Injury Severity Score (ISS) and the Glasgow Coma Scale (GCS). Traffic accident (57 per cent) and a simple fall at home (30 per cent) were the main causes of injury. ⋯ Also, the need for early intubation and continued ventilation were predictive of survival (P < 0.001). Nevertheless, this need for respiratory assistance was not an indication for withdrawing support as 9 per cent of the survivors also required endotracheal intubation for 5 days or longer. In our opinion, aggressive trauma care for the elderly is justified.