Relationship Between the Number of Patients Visiting Emergency Department and Tokyo Health System’s Capacity During Early Stages of the First Wave of COVID-19

AbstractThe first coronavirus 2019 (COVID-19) patients were reported in China on December 12, 2019, and the first COVID-19 patients were reported in Japan on January 16, 2020. Here, we investigated the number of patients in Emergency Departments (EDs) in three major hospitals in Tokyo, and also briefly discussed about the relationship between the number of patients in EDs and health system’s capacity. We compared the number of patients in 2020 to the average number of patients from 2016 to 2019. Numbers were compared in three periods: before the first COVID-19 patient was reported in Japan (January 1 to January 16), after the government encouraged social distancing (February 26 to March 10), and the interval between them (January 17 to February 25). The average number of daily patients in 2020 (n = 122) decreased by 17% compared to the average number of patients from 2016 to 2019 (n = 144) (Mann-Whitney test, p < 0.001). This phenomenon might be due to a fear of contracting the virus at hospitals, companies having their employees work remotely and postponing events, people following the Japanese Ministry of Health, Labour and Welfare’s instructional guidelines for going to the hospital, prevention awareness becoming widespread, and a decreased number of tourists. The number of patients visiting Emergency Departments in Tokyo was decreased and the number of COVID-19 infections has remained within the health system’s capacity during the early phase of COVID-19 first wave.

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598 Patients’ Knowledge and Compliance with Government Guidelines for COVID 19

British Journal of Surgery ◽

10.1093/bjs/znab134.071 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

J Eskander ◽

A Khallaf ◽

S Zaki ◽

M Elkawafi ◽

R Makar

Keyword(s):

Cognitive Impairment ◽

Hospital Stay ◽

Safe Distance ◽

Essential Information ◽

Social Distancing ◽

Viral Spread ◽

Information Leaflets ◽

Number Of Patients ◽

Male Patients ◽

The Government

Abstract Background Since the outbreak of COVID-19; social distancing and recognized effective precautions were recommended by various governments to fight the viral spread. Our aim was to assess the inpatient knowledge and compliance with the government guidelines during their hospital stay and at their discharge in two different NHS hospitals. Method The study took place in two hospitals: Berrywood hospital, UK and Countess of Chester hospital, UK. We invited inpatients to answer an anonymized questionnaire which was designed to include the contemporary government guidelines. We excluded patients with cognitive impairment and those who were not expected to be discharged within days. Results Out of 209 patients, 50% were male. Patients showed good awareness of the main symptoms of the virus (90%). However, A significant number of patients were not fully aware of the recommended precautions to minimize viral spread (28%) and the method of spread (43%). About 41% did not know the recommended safe distance. Conclusions Despite being aware of the main symptoms of COVID-19, a significant number of patients lack essential information needed to minimize the spread of the virus in the society and hospital. We recommend providing patients with information leaflets and direct advice on admission and discharge.

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The Model of Hospital Emergency Departments in 2,000 Bed Hospital in Hungary

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00030557 ◽

1986 ◽

Vol 2 (1-4) ◽

pp. 116-117

Author(s):

Attila Csepanyi ◽

Mihaly Sebestyen

Keyword(s):

Emergency Department ◽

Research Program ◽

Emergency Departments ◽

County Hospital ◽

Hospital Emergency ◽

Ministry Of Health ◽

Ground Floor ◽

Hospital Emergency Departments

The first emergency department in Hungary was established in Hetenyi Geza County Hospital in 1976. It was organized as part of a research program commissioned by the Ministry of Health. Initially, the hospital had 1400 beds which have now increased to 2,000.The Emergency Department is located on the ground floor of a new building and occupies 1,100 square meters of surface. The operation of the department is divided into three main areas.

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Investigating the relationship between how a chief complaint is expressed and the patient workflow

Journal of Emergency Practice and Trauma ◽

10.34172/jept.2020.11 ◽

2020 ◽

Vol 6 (2) ◽

pp. 63-67

Author(s):

Sajjad Ahmadi ◽

Niloufar Pouresmaeil ◽

Farima Najjarian ◽

Samad Shams Vahdati ◽

Maryam Rahimpour Asenjan ◽

...

Keyword(s):

Emergency Department ◽

Emergency Room ◽

Emergency Departments ◽

Descriptive Analysis ◽

Critical Role ◽

Kidney Injury ◽

Chief Complaint ◽

Final Decision ◽

Bloody Stool ◽

The Relationship

Objective: Emergency departments and hospital emergency departments are important due to their critical role in providing urgent medical care to patients in dire need of medical interventions. Checking bottlenecks in new conditions and planning to reduce bed occupancy and hospitalization is needed. The purpose of this study is to investigate the relationship between the patient’s chief complaint and their departure to the emergency room. Methods: From non-traumatic patients referred to the emergency department of Imam Reza Hospital during 2018, about 57000 patients were selected and enrolled in the study. Then, age, sex, initial diagnosis, time of the final decision, and time of departure from the emergency department as well as hospitalization ward were included in the checklist. Patients whose documentation was incomplete were excluded. Data were entered into SPSS software version 15.0 and descriptive statistics (normal distribution, average of time, minimum time and maximum time, confidence interval, mode, and median, etc) were used for descriptive analysis and linear regression was used to analyze the correlation among findings. Results: There was a significant relationship between chief complaint and the length of stay in the emergency department (P = 0.046) and patients with dyspnea due to heart disease, bloody vomit, bloody stool, constipation, jaundice, anemia, decreased level of consciousness, diabetes, complications of diabetes, shortness of breath and kidney injury stayed longer in the emergency room compared to other complaints. Conclusion: The patient’s manner of expressing and chief complaint has an impact on the length of time they wait to leave the emergency room. Also, most patients with problems related to internal medicine have the longest time in the emergency room; in particular gastrointestinal patients have the longest stay in the emergency room.

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Evaluating alcohol intoxication management services: the EDARA mixed-methods study

Health Services and Delivery Research ◽

10.3310/hsdr08240 ◽

2020 ◽

Vol 8 (24) ◽

pp. 1-214 ◽

Cited By ~ 1

Author(s):

Simon C Moore ◽

Davina Allen ◽

Yvette Amos ◽

Joanne Blake ◽

Alan Brennan ◽

...

Keyword(s):

Emergency Department ◽

Emergency Departments ◽

Alcohol Intoxication ◽

Ethnographic Study ◽

Acute Alcohol Intoxication ◽

Front Line ◽

Night Time ◽

Number Of Patients ◽

The Impact ◽

Management Services

Background Front-line health-care services are under increased demand when acute alcohol intoxication is most common, which is in night-time environments. Cities have implemented alcohol intoxication management services to divert the intoxicated away from emergency care. Objectives To evaluate the effectiveness, cost-effectiveness and acceptability to patients and staff of alcohol intoxication management services and undertake an ethnographic study capturing front-line staff’s views on the impact of acute alcohol intoxication on their professional lives. Methods This was a controlled mixed-methods longitudinal observational study with an ethnographic evaluation in parallel. Six cities with alcohol intoxication management services were compared with six matched control cities to determine effects on key performance indicators (e.g. number of patients in the emergency department and ambulance response times). Surveys captured the impact of alcohol intoxication management services on the quality of care for patients in six alcohol intoxication management services, six emergency departments with local alcohol intoxication management services and six emergency departments without local alcohol intoxication management services. The ethnographic study considered front-line staff perceptions in two cities with alcohol intoxication management services and one city without alcohol intoxication management services. Results Alcohol intoxication management services typically operated in cities in which the incidence of acute alcohol intoxication was greatest. The per-session average number of attendances across all alcohol intoxication management services was low (mean 7.3, average minimum 2.8, average maximum 11.8) compared with the average number of emergency department attendances per alcohol intoxication management services session (mean 78.8), and the number of patients diverted away from emergency departments, per session, required for services to be considered cost-neutral was 8.7, falling to 3.5 when ambulance costs were included. Alcohol intoxication management services varied, from volunteer-led first aid to more clinically focused nurse practitioner services, with only the latter providing evidence for diversion from emergency departments. Qualitative and ethnographic data indicated that alcohol intoxication management services are acceptable to practitioners and patients and that they address unmet need. There was evidence that alcohol intoxication management services improve ambulance response times and reduce emergency department attendance. Effects are uncertain owing to the variation in service delivery. Limitations The evaluation focused on health service outcomes, yet evidence arose suggesting that alcohol intoxication management services provide broader societal benefits. There was no nationally agreed standard operating procedure for alcohol intoxication management services, undermining the evaluation. Routine health data outcomes exhibited considerable variance, undermining opportunities to provide an accurate appraisal of the heterogenous collection of alcohol intoxication management services. Conclusions Alcohol intoxication management services are varied, multipartner endeavours and would benefit from agreed national standards. Alcohol intoxication management services are popular with and benefit front-line staff and serve as a hub facilitating partnership working. They are popular with alcohol intoxication management services patients and capture previously unmet need in night-time environments. However, acute alcohol intoxication in emergency departments remains an issue and opportunities for diversion have not been entirely realised. The nurse-led model was the most expensive service evaluated but was also the most likely to divert patients away from emergency departments, suggesting that greater clinical involvement and alignment with emergency departments is necessary. Alcohol intoxication management services should be regarded as fledgling services that require further work to realise benefit. Future work Research could be undertaken to determine if a standardised model of alcohol intoxication management services, based on the nurse practitioner model, can be developed and implemented in different settings. Future evaluations should go beyond the health service and consider outcomes more generally, especially for the police. Future work on the management of acute alcohol intoxication in night-time environments could recognise the partnership between health-care, police and ambulance services and third-sector organisations in managing acute alcohol intoxication. Trial registration Current Controlled Trials ISRCTN63096364. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 24. See the NIHR Journals Library website for further project information.

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The Swine Flu Emergency Department: The Relationship Between Media Attention for the Swine Flu and Registrations in an Emergency Medicine Unit

Prehospital and Disaster Medicine ◽

10.1017/s1049023x14000247 ◽

2014 ◽

Vol 29 (2) ◽

pp. 141-145 ◽

Cited By ~ 2

Author(s):

Sara Nelissen ◽

Kathleen Beullens ◽

Marc Sabbe ◽

Jan Van den Bulck

Keyword(s):

Emergency Department ◽

Emergency Medicine ◽

Time Frame ◽

Swine Flu ◽

Publication Type ◽

Media Report ◽

Media Attention ◽

Number Of Patients ◽

Media Reports ◽

The Relationship

AbstractIntroductionWhen the world is faced with a new potential pandemic outbreak, the media report heavily about it. Media are an important disseminator of health threat information. This study examined potential media effects during the 2009 outbreak of A/H1N1 influenza.HypothesisTo examine the relationship between media reports of the swine flu and self-registrations in an emergency department (ED) of a tertiary hospital in Flanders, Belgium.MethodsAll articles concerning swine flu published in seven Flemish newspapers were selected during the biggest flu peak in Belgium. This number was compared with the number of patients who presented themselves with a self-diagnosis of swine flu symptoms during the same time frame. The Pearson's correlation coefficient was selected to determine the relationship. The cross-correlation function determined the direction of this relationship.ResultsA strong correlation was found between the number of potential patients (n = 308) and the number of articles in the Flemish press (n = 1657). The number of patients was the leading indicator; increases in the volume of written press followed increases in the number of patients.ConclusionMedia reporting is extensive when a new infectious disease breaks out and intensifies when it is feared that pandemic levels are reached. This was also the case with the swine flu outbreak in Flanders. These findings suggest that a rise in the number of media reports follows a rise in the number of cases, rather than the reverse.NelissenS, BeullensK, SabbeM, Van den BulckJ. The Swine Flu Emergency Department: the relationship between media attention for the swine flu and registrations in an emergency medicine unit. Prehosp Disaster Med. 2014;29(2):1-5.

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Heme Oxygenase1 Level in Normotensive Pregnancy and Preeclampsia with Severe Features

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v4i3.433 ◽

2017 ◽

pp. 128

Author(s):

Christian Homenta ◽

John J Wantania ◽

Juneke J Kaeng

Keyword(s):

Pregnant Women ◽

Heme Oxygenase ◽

P Value ◽

Heme Oxygenase 1 ◽

Cross Sectional ◽

Whitney Test ◽

Mann Whitney Test ◽

Significant Difference ◽

The Relationship ◽

Normotensive Pregnancy

Objective: To understand the relationship of heme oxygenase-1 (HO-1) level between normotensive pregnancy and preeclampsia with severe features. Method: The cross sectional study was conducted in the Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sam Ratulangi/Prof. Dr. R. D. Kandou General Hospital Manado. The subjects consisted of 26 pregnant women with normal blood pressure and 26 women with severe features of preeclampsia. We took the patients’ history, general physical examination, and laboratory assessment. The blood samples were taken from normotensive women more than 20 weeks of pregnancy and preeclamptic women with severe features more than 20 weeks of pregnancy. The data obtained was processed using SPSS 20.0 software. We did the nonparametric Mann-Whitney test to analyze the relationship between heme oxygenase-1 (HO-1) level in normotensive pregnancy and preeclampsia with severe features. Result: The level of heme oxygenase-1 (HO-1) in normotensive pregnant women was at 3.24 (SD 0.58) ng/ml (95% CI 3.00-3.47), and the level of heme oxygenase-1 (HO-1) of preeclamptic women with severe features was 3.92 (SD 0.73) ng/ml (95% CI 3.62-4.21). The result of Mann-Whitney test showed p value of 0.001 which meant that there was significant difference in the level of heme oxygenase- 1 (HO-1) between normotensive women and pre-eclamptic women with severe features. Conclusion: There was the relationship between the level of heme oxygenase-1 (HO-1) and the incidence of preeclampsia with severe features. Keywords: heme oxygenase-1 (HO-1), normotensive pregnancy, preeclampsia with severe features

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Hubungan Antara Level Emergency Severity Index (ESI) dengan Kepuasan Pasien di Instalasi Gawat Darurat Rumah Sakit Sido Waras

Jurnal Administrasi Kesehatan Indonesia ◽

10.20473/jaki.v4i2.2016.97-106 ◽

2016 ◽

Vol 4 (2) ◽

pp. 97

Author(s):

Regina Kurniasari

Keyword(s):

Emergency Department ◽

Patient Satisfaction ◽

Service Quality ◽

Severity Index ◽

Hospital Emergency Department ◽

Preliminary Survey ◽

Emergency Severity Index ◽

Hospital Emergency ◽

Number Of Patients ◽

The Relationship

The number of patients in Sido Waras Hospital Emergency Department declined since in 2013 until 2015 and the preliminary survey also showed there were complex complaints emergency department services. Therefore, the purpose of this study was to analyze the relationship between the service and the satisfaction of patients in Sido Waras Hospital Emergency Department.The concept of ESI Sido Waras Hospital Emergency Department namely provided categories of patients based on the gravity and duration of patient management.Therefore in this study to analyze the relationship with the ESI level of patient satisfaction in the Sido Waras Hospital Emergency Department. This study was a survey.Keywords : Emergency department, ESI level, patient satisfaction, service quality

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(A22) Impact of Karachi Terrorist Bombing on an Emergency Department of a Tertiary Care Hospital

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11000355 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s6-s7

Author(s):

H. Waseem ◽

S. Shahbaz ◽

J. Razzak

Keyword(s):

Emergency Department ◽

Tertiary Care Hospital ◽

Wound Care ◽

Tertiary Care ◽

Care Facility ◽

Care Hospital ◽

Disaster Plan ◽

Tertiary Care Facility ◽

Number Of Patients ◽

The Government

ObjectivesThe objective of this study was to collect epidemiological injury data on patients presenting to the emergency department of a tertiary care hospital after the bombing on 29 December 2009.MethodsThis was a retrospective review of the medical records of the victims that were brought to a tertiary care hospital. Bombing victims were described as requiring acute care due to the direct effect of the bombing.ResultsThe results are derived from a sample size of 198 bomb blast victims, most of which were first transported to government hospitals by private cars rather than ambulances. After the government announced free treatment, there was a wave of patients, among which, most were stable and already had received some form of treatment. Approximately 5–6 patients who had life-threatening injuries were brought directly to the tertiary care facility and needed surgical intervention. The lack of security in the emergency department could have lead to another terrorist activity. There were no procedures done in the field as there is lack of emergency medical services training in Pakistan, but in the hospital most of the interventions included intravenous (IV) lines, wound care, and laceration repair. The most common treatments included the administration of IV fluids, antibiotics, and analgesia. Radiographs of specific sites and trauma series were used to rule out bone injuries. There was lack of documentation in most of the medical charts.ConclusionsThe emergency department was overwhelmed with the number of patients that it received. Therefore, an updated disaster plan and regular disaster drills are required. Rapid and accurate triage could minimize mortality among bombing survivors significantly. The majority of patients were discharged home.

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Do elective surgical and medical admissions impact emergency department length of stay measurements?

Clinical & Investigative Medicine ◽

10.25011/cim.v30i5.2893 ◽

2007 ◽

Vol 30 (5) ◽

pp. 177 ◽

Cited By ~ 7

Author(s):

Trevor S Langhan

Keyword(s):

Emergency Department ◽

Regression Analysis ◽

Linear Regression ◽

Length Of Stay ◽

Acute Care ◽

Emergency Departments ◽

Linear Regression Analysis ◽

Wait Times ◽

Health Region ◽

The Relationship

Background: Emergency department access block is a growing problem in emergency departments across Canada. Access block is defined as hospital occupancy >85% causing emergency department overcrowding. Hospital overcrowding leads to prolonged emergency department wait times, and delays in the transfer of admitted patients from the emergency department to inpatient beds. The relationship between elective admissions to hospital and emergency department wait times has not been adequately assessed. We undertook a simple linear regression analysis of the impact of elective admissions to hospital on emergency department length of stay. Methods: Linear regression analysis of the number of daily elective admissions to adult acute care beds in the Calgary Health Region in the year 2004 and the daily median emergency department length of stay was done to establish the relationship between elective admissions and Emergency Department length of stay. Results: 37,007 patients were admitted to adult acute care beds via the emergency department and 46,020 patients were admitted to adult acute care beds by all other routes. Regression analysis determined that there was no relationship between daily emergency department length of stay and the number of elective admissions per day. Conclusion: For the year 2004, in the Calgary Health Region, elective acute care admissions to hospital had no relationship to emergency department length of stay for patients admitted via the emergency department. Further study is required to determine causative factors that prolong Emergency Department length of stay. Emergency departments across Canada continue to struggle with the demands of providing high quality care with diminishing resources.

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PERAN KONTAK TANI DALAM BUDIDAYA PADI ORGANIK DI KECAMATAN MOJOGEDANG KABUPATEN KARANGANYAR

AGRITEXTS: Journal of Agricultural Extension ◽

10.20961/agritexts.v43i1.41625 ◽

2020 ◽

Vol 43 (1) ◽

pp. 8

Author(s):

Rinjani Alam Pratiwi ◽

Suwarto Suwarto ◽

Arip Wijianto

Keyword(s):

Quantitative Method ◽

Rice Cultivation ◽

Spearman Correlation ◽

Correlation Test ◽

Whitney Test ◽

Organic Rice ◽

Mann Whitney Test ◽

Spearman Correlation Test ◽

The Relationship

This research aims at studying organic rice cultivation, the role of kontak tani in organic rice cultivation, the relationship between the role of kontak tani and organic rice cultivation, and whether there is a difference among the role of kontak tani according to farmers that is based on farming education, the expanse of farming field and farming environment. The role of kontak tani covers the role as a leader, a model, a preceptor, an activator and an instructor colleague. This research is conducted using quantitative method. The technique of sampling is sensus method with total number of 60 sample respondents from two farming groups under research. The data of the research is analysed using Rank Spearman correlation test dan U Mann Whitney test.The result of the correlation test shows that the relationship between the role of kontak tani as a leader and as a preceptor towards organic rice cultivation is very significant, and the relationship between the role of kontak tani as an activator towards organic rice cultivation is significant, while the role of kontak tani as a model and an instructor colleague towards organic rice cultivation is insignificant. According to U Mann Whitney test, there is no significant differences regarding the role of kontak taniaccording to farmers based on farming education, the expanse of farming field and farming environment.

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