Articles: emergency-services.
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Traditionally, treatment in the emergency department is noted for brief doctor-patient encounters, fragmented service, and lack of follow-up care. This atmosphere can lead to patient dissatisfaction and may contribute to the high rate of noncompliance with discharge instructions and medications. To cope with this problem, a prospective study was designed to evaluate a telephone follow-up system and its effect on patient care and satisfaction. ⋯ Of the patients contacted 42% (97/229) required further clarification of their discharge instructions. The calls resulted in direct medical intervention in the majority of patients (6/7) who stated their clinical condition had worsened. Ninety-five percent of the patients questioned (112/118) felt that the call was useful.(ABSTRACT TRUNCATED AT 250 WORDS)
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We performed a ten-week study to understand the feasibility of a fast track system within a teaching hospital setting. Our results show that 50% or fewer of patients entering an emergency department during evening and weekend day hours can be seen in Fast Track. Average turnaround time for all patients in the ED was 161 minutes. ⋯ Roentgenograms of the ankle, foot, and knee accounted for 80% of all radiographs. An evaluation questionnaire showed enhanced satisfaction with a reduction in the number of complaints from 79% to 22%. The Fast Track system failed when there was a predominance of acutely ill patients in the ED, as house officers were pulled to care for the acutely ill patients.
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The American surgeon · Apr 1988
Impact of emergency room laboratory studies on the ultimate triage and disposition of the injured child.
One hundred sixty six surviving pediatric trauma patients were retrospectively studied to assess the contribution of initial laboratory evaluations to clinical decision making in the emergency department (ED). All laboratory tests ordered, the results of those tests and the number of test results available before patient disposition from the ED were reviewed. A total of 626 laboratory studies were ordered in 166 patients. ⋯ Based on this data, the current protocol has been revised to include hemoglobin/hematocrit determinations, type and screen, and urinalysis. Additional blood is obtained and appropriately labeled so that further studies can be performed if the patient's management should require baseline laboratory evaluations. This approach is more efficient, cost-effective, and no less sensitive in the initial evaluation and management of the injured child.