Improving Timeliness and Access of Acute and Emergency Care: The Science of Improving Emergency Department Crowding

2017 ◽  
pp. 38-45
Author(s):  
Olan A. Soremekun
Keyword(s):  
Emergency Department ◽  
Emergency Care ◽  
Emergency Department Crowding

scholarly journals Correction to: Validation of the modified Skåne emergency department assessment of patient load (mSEAL) model for emergency department crowding and comparison with international models; an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jens Wretborn ◽  
Håkan Starkenberg ◽  
Thoralph Ruge ◽  
Daniel B. Wilhelms ◽  
Ulf Ekelund
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Emergency Department Crowding ◽  
Patient Load

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals The International Federation for Emergency Medicine report on emergency department crowding and access block: a brief summary

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
A. P. Javidan ◽  
◽  
K. Hansen ◽  
I. Higginson ◽  
P. Jones ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Task Force ◽  
Video Conferencing ◽  
International Federation ◽  
Emergency Physicians ◽  
Emergency Department Crowding ◽  
Comprehensive Guidance ◽  
The World ◽  
Ed Crowding

Abstract Objective To develop comprehensive guidance that captures international impacts, causes, and solutions related to emergency department crowding and access block Methods Emergency physicians representing 15 countries from all IFEM regions composed the Task Force. Monthly meetings were held via video-conferencing software to achieve consensus for report content. The report was submitted and approved by the IFEM Board on June 1, 2020. Results A total of 14 topic dossiers, each relating to an aspect of ED crowding, were researched and completed collaboratively by members of the Task Force. Conclusions The IFEM report is a comprehensive document intended to be used in whole or by section to inform and address aspects of ED crowding and access block. Overall, ED crowding is a multifactorial issue requiring systems-wide solutions applied at local, regional, and national levels. Access block is the predominant contributor of ED crowding in most parts of the world.

scholarly journals Use of a Unique Mobile Medical Asset in COVID Monoclonal Antibody Treatment

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 990
Author(s):  
Herman Morchel ◽  
David Clark ◽  
Leighanne Buenvenida ◽  
Chinwe Ogedegbe
Keyword(s):  
Emergency Department ◽  
Monoclonal Antibody ◽  
Patient Care ◽  
Emergency Care ◽  
Environmental Changes ◽  
Physical Space ◽  
Antibody Treatment ◽  
Monoclonal Antibody Treatment ◽  
Mobile Satellite ◽  
Novel Coronavirus

The COVID-19 pandemic and the subsequent surge of patients presented to emergency departments has forever changed the paradigm of delivering emergency care. The highly infectious nature of the 2019 Novel Coronavirus, or COVID-19, mandated strict environmental changes, novel patient care, and flexible strategies to continue to deliver efficient emergency care while maintaining appropriate physical distancing between suspect and non-suspect COVID-19 patients. The engagement of a unique rapidly deployable Mobile Satellite Emergency Department (MSED) with scalable capability from prompt care to resuscitation level allowed the emergency care team to optimize patient care and throughput. The MSED was strategically located adjacent to the ambulance entrance. While initially deployed to increase Emergency Department surge capacity, the MSED was repurposed to cohort and treat COVID patients with the monoclonal antibody, Bamlanivimab, who were expected to be discharged after treatment. This allowed for more efficient use of Emergency Department resources, including physical space and staffing.

scholarly journals Reaching Out of the Box: Effective Emergency Care Requires Looking Outside the Emergency Department

2016 ◽  
Vol 17 (4) ◽  
pp. 484-486 ◽  
Author(s):  
Daniel Dworkis ◽  
David Peak ◽  
Jason Ahn ◽  
Tony Joseph ◽  
Ed Bernstein ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Care

Tracking the Rise of Geriatric Emergency Departments in the United States

2018 ◽  
Vol 39 (8) ◽  
pp. 871-879 ◽  
Author(s):  
John G. Schumacher ◽  
Jon Mark Hirshon ◽  
Phillip Magidson ◽  
Marilyn Chrisman ◽  
Terisita Hogan
Keyword(s):  
Emergency Department ◽  
Emergency Care ◽  
Emergency Departments ◽  
The United States ◽  
Transitions Of Care ◽  
Emergency Department Care ◽  
Equipment And Supplies ◽  
Care Services ◽  
Physical Environments

The traditional model of emergency care no longer fits the growing needs of the over 20 million older adults annually seeking emergency department care. In 2007 a tailored “geriatric emergency department” model was introduced and rapidly replicated among hospitals, rising steeply over the past 5 years. This survey examined all U.S. emergency departments self-identifying themselves as Geriatric Emergency Departments (GEDs) and providing enhanced geriatric emergency care services. It was guided by the recently adopted Geriatric Emergency Department Guidelines and examined domains including, GED identity, staffing, and administration; education, equipment, and supplies; policies, procedures, and protocols; follow-up and transitions of care; and quality improvement. Results reveal a heterogeneous mix of GED staffing, procedures, physical environments and that GEDs’ familiarity with the GED Guidelines is low. Findings will inform emergency departments and gerontologists nationwide about key GED model elements and will help hospitals to improve ED services for their older adult patients.

scholarly journals Results on sports-related injuries in children from NHS emergency care dataset Oxfordshire pilot: an ecological study

2018 ◽  
Vol 112 (3) ◽  
pp. 109-118 ◽  
Author(s):  
Graham Kirkwood ◽  
Thomas C Hughes ◽  
Allyson M Pollock
Keyword(s):  
Emergency Department ◽  
Emergency Care ◽  
Ecological Study ◽  
Bone Fractures ◽  
Age Groups ◽  
Sports Injury ◽  
Rugby Union ◽  
Data Set ◽  
Horse Riding ◽  
Injury Data

Summary Objectives To analyse and report on sports-related injuries using enhanced injury data collected by the testbed for the NHS emergency care injury data set and admissions data collected from inpatients. Design Ecological study design. Setting Two Oxfordshire NHS England hospitals. Participants Emergency department attendees and inpatients aged 0–19 years with sports injuries. Main outcome measures Data were analysed from 1 January 2012 to 30 March 2014 by age, gender sport, injury location, injury mechanism and diagnosis including concussion/post-concussion, bone fractures and ligament damage. Admissions data were analysed from 1 January 2012 to 24 January 2015. Results Children and adolescents aged 0–19 years accounted for almost half (47.4%) of sports injury-related emergency department attendances and almost one-quarter (23.5%) of sports injury-related admissions for all ages. The highest rates of attendance occurred at 14 years for boys (68.22 per 1000 person-years) and 12 years for girls (33.72 per 1000 person-years). For male 0–19-year-olds the three main sports were (in order) football (soccer), rugby union and rugby league and for females, trampoline, netball and horse-riding. The largest gender differences were in netball where injuries were predominantly in females and in wheeled motorsports where injuries were predominantly in males. Almost one-quarter of emergency department sports-related injuries recorded were fractures, the highest percentage to the upper limbs. Conclusions Public health departments in local authorities and schools should consider target sports injury prevention at children in the first four years of secondary school. For younger age groups, trampolines in the home warrant improved safety. Rugby and horse-riding should also be a focus for interventions.

scholarly journals Appropriateness of cases presenting in the emergency department following ambulance service secondary telephone triage: a retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016845 ◽  
Author(s):  
Kathryn Eastwood ◽  
Karen Smith ◽  
Amee Morgans ◽  
Johannes Stoelwinder
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Emergency Care ◽  
Retrospective Cohort ◽  
Care Pathway ◽  
Cohort Analysis ◽  
Care Pathways ◽  
Telephone Triage ◽  
Alternative Care ◽  
Referral Service

ObjectiveTo investigate the appropriateness of cases presenting to the emergency department (ED) following ambulance-based secondary telephone triage.DesignA pragmatic retrospective cohort analysis of all the planned and unplanned ED presentations within 48 hours of a secondary telephone triage.SettingThe secondary telephone triage service, called the Referral Service, and the hospitals were located in metropolitan Melbourne, Australia and operated 24 hours a day, servicing 4.25 million people. The Referral Service provides an in-depth secondary triage of cases classified as low acuity when calling the Australian emergency telephone number.PopulationCases triaged by the Referral Service between September 2009 and June 2012 were linked to ED and hospital admission records (N=44,523). Planned ED presentations were cases referred to the ED following the secondary triage, unplanned ED presentations were cases that presented despite being referred to alternative care pathways.Main outcome measuresAppropriateness was measured using an ED suitability definition and hospital admission rates. These were compared with mean population data which consisted of all of the ED presentations for the state (termed the ‘average Victorian ED presentation’).ResultsPlanned ED presentations were more likely to be ED suitable than unplanned ED presentations (OR 1.62; 95% CI 1.5 to 1.7; p<0.001) and the average Victorian ED presentation (OR 1.85; 95% CI 1.01 to 3.4; p=0.046). They were also more likely to be admitted to the hospital than the unplanned ED presentation (OR 1.5; 95% CI 1.4 to 1.6; p<0.001) and the average Victorian ED presentation (OR 2.3, 95% CI 2.24 to 2.33; p<0.001). Just under 15% of cases diverted away from the emergency care pathways presented in the ED (unplanned ED attendances), and 9.5% of all the alternative care pathway cases were classified as ED suitable and 6.5% were admitted to hospital.ConclusionsSecondary telephone triage was able to appropriately identify many ED suitable cases, and while most cases referred to alternative care pathways did not present in the ED. Further research is required to establish that these were not inappropriately triaged away from the emergency care pathways.

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