Articles: emergency-services.
-
This study was conducted to explain a more than threefold increase in anticipated patient visits associated with the opening of a separate pediatric emergency department (PED) 2 miles from the nearest general emergency department. Population demographics and data pertaining to visits to other emergency departments were obtained. Parents visiting the new PED were surveyed using a standardized questionnaire. ⋯ We conclude that the increase in visits cannot be accounted for by increases in regional population base only. Anticipated patient volume to a new health care facility should not be based on population demographics only, but on other factors such as user perception of facility. Patient or parent preference should also be considered.
-
The medical profession has made utilization review a priority in its efforts to limit health care expenditures. In emergency medicine this has ranged from initiatives to limit inappropriate emergency department visits to guidelines to limit emergency department testing and criteria to limit hospital admissions. The emergency department observation unit is an area in which the emergency physicians follow these practice guidelines without compromising patient care. The emergency department utilization review/quality assurance committee is a management tool by which emergency physicians monitor and implement these strategies for cost-effective patient care.
-
The approach emergency medical service (EMS) systems take to quality assurance and quality improvement is evolving rapidly. Methods of quality assurance that have been applied to the prehospital care environment are reviewed. Impediments to effective quality assurance strategies are discussed and an overview of the scope of the activities and resources necessary to perform this task is presented. The potential efficacy and limitations of quality improvement in EMS are also discussed.