P044: Register to donate while you wait: assessing public acceptability of utilizing the emergency department waiting room for organ and tissue donor registration

Introduction: Our study objectives were to assess the acceptability of using the emergency department (ED) waiting room to provide knowledge on, and offer opportunities for organ and tissue donor registration; and to identify barriers to the donor registration process in Ontario. Methods: We conducted a paper based in-person survey over nine days for eight hour blocks in March and April 2017. The survey instrument was created in English using existing literature and expert opinion, pilot tested and then translated into French. The study collected data from patients and visitors in an urban academic Canadian tertiary care ED waiting room. All adults in the waiting room were approached to participate during the study periods. Individuals waiting in clinical care areas were excluded, as well as those who required immediate treatment. Results: The number of attempted surveys was 324; 67 individuals (20.7%) refused to partake. A total of 257 surveys were distributed and five were returned blank. This gave us a response rate of 77.8% with 252 completed surveys. The median age group was 51-60 years old with 55.9% female. Forty-six percent were Christian (46.0%) and 34.1% did not declare a religious affiliation. Nearly half of participants (44.1%) were registered organ donors. The majority of participants agreed or were neutral (83.3%) that the ED waiting room was an acceptable place to provide information on organ and tissue donation. Further, 82.1% agreed or were neutral that the ED was an acceptable place to register as an organ donor. Nearly half (47.2%) agreed that they would consider registering while in the ED waiting room. A number of barriers to registering as an organ and tissue donor were identified. The most common were: not knowing how to register (22.0%), a lack of time to register (21.1%), and having unanswered questions regarding organ and tissue donation (18.7%). Conclusion: Individuals waiting in the ED are supportive of using the ED waiting room for distributing information regarding organ and tissue donation, and facilitating organ and tissue donation registration. Developing such a practice could help to reduce some of the identified barriers, including a lack of time and having unanswered questions regarding donation.

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Register to donate while you wait: Assessing public opinions of the acceptability of utilizing the emergency department waiting room for organ and tissue donor registration

CJEM ◽

10.1017/cem.2019.347 ◽

2019 ◽

Vol 21 (5) ◽

pp. 622-625 ◽

Cited By ~ 1

Author(s):

Brittany Ellis ◽

Michael Hartwick ◽

Jeffrey J. Perry

Keyword(s):

Emergency Department ◽

Organ Donation ◽

Response Rate ◽

Religious Affiliation ◽

Tertiary Care ◽

Tissue Donation ◽

Age Group ◽

Waiting Room ◽

Tissue Donor ◽

Registration Process

ABSTRACTObjectiveOur objectives were to identify barriers to the organ donation registration process in Ontario; and to determine the acceptability of using the emergency department (ED) waiting room to provide knowledge and offer opportunities for organ and tissue donor registration.MethodsWe conducted a paper based in-person survey over nine days in March and April 2017. The survey instrument was created in English using existing literature and expert opinion, pilot tested and then translated into French. Data was collected from patients and visitors in an urban academic Canadian tertiary care ED waiting room. All adults in the waiting room were approached to participate during study periods. We excluded patients who were too ill and required immediate treatment.ResultsThe number of attempted surveys was 324; 67 individuals (20.7%) declined participation. A total of 257 surveys were distributed and five were returned blank. This gave us a response rate of 77.8% with 252 completed surveys. The median age group was 51–60 years old with 55.9% female. Forty-six percent reported their religion as Christian and 34.1% did not declare a religious affiliation. 44.1% were already registered donors. Most participants agreed or were neutral that the ED waiting room was an acceptable place to provide information on donation, and for registration as an organ and tissue donor (83.3% and 82.1%, respectively).ConclusionsIndividuals waiting in the ED are generally supportive of using the waiting room for distributing information regarding organ and tissue donation, and to allow donor registration.

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CAEP Position Statement – Management of devastating brain injuries in the emergency department: Enhancing neuroprognostication and maintaining the opportunity for organ and tissue donation – ERRATUM

CJEM ◽

10.1017/cem.2020.468 ◽

2020 ◽

Vol 22 (5) ◽

Author(s):

Andrew Healey ◽

Murdoch Leeies ◽

Carmen Hrymak ◽

Alecs Chochinov ◽

Brian Grunau ◽

...

Keyword(s):

Emergency Department ◽

Brain Injuries ◽

Position Statement ◽

Tissue Donation ◽

Organ And Tissue Donation

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MP05: Injuries in refugee children presenting to a paediatric emergency department

CJEM ◽

10.1017/cem.2018.159 ◽

2018 ◽

Vol 20 (S1) ◽

pp. S41-S42

Author(s):

E. Zhang ◽

F. Razik ◽

S. Ratnapalan

Keyword(s):

Primary Care ◽

Emergency Department ◽

Primary Care Physicians ◽

Clinical Care ◽

Tertiary Care ◽

Primary Care Providers ◽

Refugee Children ◽

Medical Attention ◽

Care Providers ◽

Ed Visits

Introduction: The number of refugees accepted to Canada grew from 24,600 in 2014 to 46,700 in 2016. Many of these refugees have young families and the number of child refugees has increased accordingly. Although child refugee health care has been in the forefront of media and medical attention recently, there is limited data on injury patterns in this population. Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) collects data on injuries in children presenting to the emergency department (ED). Our objective is to examine the clinical presentations and outcomes of refugee children with injuries presenting to a tertiary care paediatric ED. Methods: Our paediatric hospital has approximately 70,000 ED visits per year of which 13,000 are due to injuries and/or poisonings. The CHIRPP database was accessed to identify children with injuries presenting to our ED from April 2014 to March 2017 with Interim Federal Health Program (IFHP) registration status. All patient charts were reviewed to extract demographic and clinical care information. Results: There were 74 children with 81 ED visits during the study period of whom 19% were transferred from other facilities. Most of them (72%) were males with a mean age of 8.7 years (standard deviation 4.29). There were significant medical histories in 32% of children. The presentation to our ED (greater than 24 hours post-injury) was seen in 25% of visits. Twenty five percent of injured children were seen in our ED. The distribution of Canadian Triage Acuity Score (CTAS) scores 1, 2, 3, 4, and 5 were 0%, 16%, 37%, 46% and 1% respectively. However, subspecialty consultations were required in 69%, 60% and 27% of CTAS 2, 3 and 4 children respectively. Overall, 46% of all patients required subspecialty consults. The top three categories of injuries include fractures (23%), soft tissue injuries (20%) and lacerations (17%). More than half (56%) required diagnostic imaging. Most (89%) were treated in ED and discharged (average length-of-stay 3 hours 55 minutes) and 11% required admissions. 47% of children lacked primary care physicians. Conclusion: Almost half of refugee children with IFHP status require DI testing, sub-specialty consultations and primary care referrals when presenting to our ED with injuries. Follow up arrangements are needed as many do not have access to primary care providers. This demonstrates a need for securing primary care providers early for this vulnerable population.

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ORGAN AND TISSUE DONATION FROM THE EMERGENCY DEPARTMENT

Critical Care Medicine ◽

10.1097/00003246-199012001-00150 ◽

1990 ◽

Vol 18 (Supplement) ◽

pp. S254

Author(s):

Richard R. Riker ◽

Bruce White

Keyword(s):

Emergency Department ◽

Tissue Donation ◽

Organ And Tissue Donation

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Parental experiences and preferences as participants in pediatric research conducted in the emergency department

CJEM ◽

10.1017/cem.2017.22 ◽

2017 ◽

Vol 20 (3) ◽

pp. 409-419 ◽

Cited By ~ 1

Author(s):

Antonia S. Stang ◽

Stephen B. Freedman ◽

Angelo Mikrogianakis ◽

Graham C. Thompson ◽

Janie Williamson ◽

...

Keyword(s):

Emergency Department ◽

Tertiary Care ◽

Cross Sectional Study ◽

Pediatric Research ◽

Waiting Room ◽

Cross Sectional ◽

Web Based ◽

Parental Experiences ◽

Separate Area

ABSTRACTObjectiveTo determine parental experiences and preferences regarding the conduct of pediatric research in an emergency department (ED) setting.MethodsWe conducted a cross-sectional study of parents of children ages 0 – 14 years who visited the ED of a tertiary care children’s hospital. Parents completed a Web-based survey designed to assess perceptions regarding: 1) background/training of research personnel, 2) location and timing of research discussions, and 3) factors influencing their consent/refusal decision.ResultsParents totalling 339 were approached, and 227 (67%) surveys were completed. Overall, 87% (197/227; 95% confidence interval [CI] 83, 92) reported they would be comfortable being approached by a university student to discuss research. This proportion did not change when stratified by the child’s gender, illness severity, or season of visit. Whereas only 37% (84/227; 95% CI 31, 43) of respondents would be comfortable being approached in the waiting room, 68% (154/227; 95% CI 62, 75) would be comfortable if approached in a separate area of the main waiting room. The majority reported comfort with follow-up via email (83%; 188/227; 95% CI 78, 88) or telephone (80%; 182/227; 95% CI 75, 85); only 51% (116/227; 95% CI 44, 57) would be comfortable with a scheduled follow-up visit in the hospital. Participants identified potential complications or side effects as the most common reason for declining consent (69%; 157/227; 95% CI 63, 75).ConclusionsThe majority of parents are comfortable being approached by trained university students, preferably in a separate area of an ED waiting room, and email and telephone follow-ups are preferred over a scheduled re-visit.

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A Gift of Generosity—An Explanation of Organ and Tissue Donation and Transplantation for Muslim Audiences

Religions ◽

10.3390/rel12100815 ◽

2021 ◽

Vol 12 (10) ◽

pp. 815

Author(s):

Mohammad Abdus Sayek Khan

Keyword(s):

Organ Donation ◽

Life Support ◽

Organ Donor ◽

Tissue Donation ◽

Loved One ◽

Organ And Tissue Donation ◽

Lack Of Information ◽

The Family ◽

End Stage

Diseased Organ and tissue donation and transplantation entails removing organ and tissues from someone (the donor) and transplanting them into another person (the recipient). Transplanting organs and tissues from one person hold the capacity to save or significantly improve the quality of life of multiple recipients. This is a rare opportunity for one to become an organ donor. In 2018, Australia had a population of 24.99 million. A total of 160,909 lives were lost that year; almost half of this death occurred in hospitals. However, a person may only be able to become a donor if their death occurs in a particular way and fulfils a defined set of special criteria—for example, while on the life support machine in an intensive care unit. Because of this, only 1211 people out of the large number of lives lost in 2018 were eligible to be potential organ donors. This is one of reasons we encourage everybody to consider the virtues of organ and tissue donation in any end-of-life discussion. Diseased organ donation occurs only when the clinician is certain that the person has died. The death is diagnosed by neurological criteria or by circulatory criteria which are discussed in detail in the article. This is an unconditional altruistic and non-commercial act. A large number of people are waiting on transplant list in Australia who are suffering from end stage organ failure; some of them will die waiting unless one receives an organ transplantation. Australians are known to be highly generous people. That is why 98% of Australian say ‘Yes’ to become an organ donor when they die. But in reality, only about 64% of families consent for organ donation on an average. There are widespread misconceptions and myths about this subject, mostly due to lack of information and knowledge. I have attempted to explain the steps of diseased organ donation in this article which, hopefully will be able to break some of those misconceptions. I have avoided to discuss living donation which is entirely a different subject. I have only touched on Islamic perspective of organ donation here as multiple Islamic scholars are going to shed lights here. We encourage everybody to ‘Discover’ the facts about organ and tissue donation, to make an informed ‘Decision’ and ‘Discuss’ this with the family. If the family knows the wishes of the loved one, it makes their decision-making process much easier during such a devastating and stressful time.

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Improving emergency department patient-doctor conversation through an artificial intelligence symptom taking tool: an action-oriented design pilot study

10.1101/2020.11.13.20230953 ◽

2020 ◽

Cited By ~ 1

Author(s):

Justus Scheder-Bieschin ◽

Bibiana Blümke ◽

Erwin de Buijzer ◽

Fabian Echterdiek ◽

Júlia Nacsa ◽

...

Keyword(s):

Emergency Department ◽

Clinical Care ◽

Interdisciplinary Treatment ◽

Future Research ◽

Study Phase ◽

History Taking ◽

Two Phase ◽

Waiting Room ◽

Time Saving ◽

Record Keeping

AbstractIMPORTANCECommunication between patients and healthcare professionals is frequently challenging in the crowded emergency department (ED), with few opportunities to develop rapport or empathy. Digital tools for patients and physicians have been proposed as helpful but their utility is not established.OBJECTIVETo evaluate a patient-facing digital symptom and history taking, as well as handover tool in the waiting room.DESIGNA two-phase, questionnaire-based quality improvement study. Phase I observations guided iterative improvement, which was then further evaluated in Phase II.SETTINGED of a German tertiary referral and major trauma hospital providing interdisciplinary treatment for an average of 120 patients daily.PARTICIPANTSAll patients who were willing/able to provide consent, excluding patients: (i) with severe injury/illness requiring immediate treatment; (ii) with traumatic injury; (iii) incapable of completing a health assessment; or, (iv) under 18 years old. Of 1699 patients presenting to the ED, 815 were eligible based on triage level. With available recruitment staff, 135 were approached, of whom 81 were included in the study.INTERVENTION/OBSERVATIONPatients entered information into the tool, which generated a handover report to be accessed via a clinician dashboard. All users completed evaluation questionnaires. Clinicians were trained to observationally assess the tool as a prototype, without relying upon it for clinical care.MAIN OUTCOMES AND MEASURESPatient and clinician Likert scale ratings of tool performance.RESULTSRespondents were strongly positive in endorsing the tool’s usefulness in facilitating conversation (75% of patients, 73% physicians, 100% nurses). Nurses judged the tool as potentially time saving, whilst physicians assessed it as time saving only in some ED medical specialisms (e.g. Surgery). Patients understood the tool questions and reported high usability. The proportion of patients, physicians and nurses who would recommend the tool was 78%, 53% and 76%.CONCLUSIONS AND RELEVANCEThe system has clear potential to improve patient-HCP interaction and make efficiency savings in the ED. Future research and development will extend the range of patients for which the history collection has clinical utility.Key PointsQuestionCan a patient-facing digital symptom and clinical history taking tool provide conversational support, aid in symptom taking, facilitate record keeping, and lead to improved rapport between patients, physicians and nurses in the emergency department (ED)?FindingsAcceptability was high, with improved rapport experienced 90% of the time for patients, 73% for physicians and 100% for nurses. Nurses assessed the tool as having workflow benefit through potential time saving. Physicians assessed the current tool design as providing time saving in certain ED medical specialisms including Surgery.MeaningThe patient-facing tool for symptom and history taking provided meaningful conversation support and showed potential for efficiency savings, however, further research and testing is required before time savings can be consistently delivered to ED clinicians across the range of relevant ED medical specialisms.

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Resource barriers to the facilitation of organ and tissue donation reported by Australian emergency clinicians

Australian Health Review ◽

10.1071/ah11121 ◽

2013 ◽

Vol 37 (1) ◽

pp. 60 ◽

Cited By ~ 1

Author(s):

Claudia H. Marck ◽

George A. Jelinek ◽

Sandra L. Neate ◽

Bernadine M. Dwyer ◽

Bernadette B. Hickey ◽

...

Keyword(s):

Emergency Department ◽

Online Survey ◽

Tissue Donation ◽

Donor Pool ◽

Potential Donor ◽

Cross Sectional ◽

Work Related ◽

Organ And Tissue Donation ◽

Ed Overcrowding ◽

Related Stress

Objective. To explore emergency department clinicians’ perceived resource barriers to facilitating organ and tissue donation (OTD). Methods. A cross-sectional national online survey of Australian emergency department (ED) clinicians. Results. ED clinicians reported a range of resource barriers that hinder the facilitation of OTD, most notably a lack of time to discuss OTD with a patient’s family (74.6%). Those reporting more resource barriers had been less involved in OTD-related tasks. For example, those reporting a lack of time to assess a patient’s suitability to be a potential donor had less experience with OTD-related tasks in the last calendar year than did those who reported that they often or always have enough time for this (P < 0.01). In addition, ED clinicians working in DonateLife network hospitals were more involved in OTD-related tasks (P < 0.01) and reported fewer resource shortages in the ED and the hospital overall. Conclusions. Resource shortages hinder the facilitation of OTD in the ED and are related to decreased involvement in OTD-related tasks. In addition, ED clinicians working in DonateLife hospitals are more involved in OTD-related tasks and report fewer resource shortages overall. Addressing resource shortages and extending the DonateLife network could benefit OTD rates initiated from the ED. What is known about the topic? Increasing the rate of organ and tissue donation (OTD) has become progressively more urgent as waiting lists for organs and tissues are growing globally. Recently a missed potential donor pool was recognised in emergency departments (EDs) and the Organ and Tissue Authority implemented a ‘clinical trigger’ tool to aid with the identification of potential donors in EDs. However, many Australian studies have reported worsening ED overcrowding and resource shortages in recent years with an adverse effect on patient care and satisfaction as well as on ED clinicians’ work-related stress and satisfaction. International literature has identified that certain resource barriers hinder the facilitation of organ and tissue in EDs. However, there is currently no literature available on how resource barriers in Australian EDs affect the facilitation of OTD. What does this paper add? Our study shows that Australian ED clinicians perceive a range of resource barriers that hinder the facilitation of OTD, most notably a lack of time to discuss OTD with a patient’s family or to identify potential donors. We also found that those reporting more resource barriers had been less involved in OTD-related tasks in the last calendar year. In addition, those that work in hospitals that are part of the DonateLife network, and thus have dedicated staff available for OTD-related tasks, were more involved in OTD-related tasks and reported fewer resource shortages in the ED and the hospital overall. What are the implications for practitioners? To maximize the number of potential donors recognised and referred from the ED, it may be important to decrease the resource barriers identified in this study. Notably, the presence of specialist OTD staff, a function of being part of a DonateLife network hospital, may result in a decreased perception of resource barriers in the ED and more engagement with OTD-related tasks by ED clinicians.

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