scholarly journals P108: Characterizing use of next-day ultrasound from the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S103
Author(s):  
C. Roberts ◽  
T. Oyedokun ◽  
B. Cload ◽  
L. Witt
Keyword(s):  
Emergency Department ◽  
Patient Care ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Improve Patient Care ◽  
Additional Stress ◽  
Start Date ◽  
The Mean ◽  
Tertiary Care Hospitals ◽  
Improve Patient

Introduction: Formal ultrasound imaging, with use of ultrasound technicians and radiologists, provides a valuable diagnostic component to patient care in the Emergency Department (ED). Outside of regular weekday hours, ordering formal ultrasounds can produce logistical difficulties. EDs have developed protocols for next-day ultrasounds, where the patient returns the following day for imaging and reassessment by an ED physician. This creates additional stress on ED resources – personnel, bed space, finances – that are already strained. There is a dearth of literature regarding the use of next-day ultrasounds or guidelines to direct efficient use. This study sought to accumulate data on the use of ED next-day ultrasounds and patient oriented clinical outcomes. Methods: This study was a retrospective chart review of 150 patients, 75 from each of two different tertiary care hospitals in Saskatoon, Saskatchewan. After a predetermined start date, convenience samples were collected of all patients who had undergone a next-day ultrasound ordered from the ED until the quota was satisfied. Patients were identified by an electronic medical record search for specific triage note phrases indicating use of next-day ultrasounds. Different demographic, clinical, and administrative parameters were collected and analyzed. Results: Of the 150 patients, the mean age was 35.9 years and 75.3% were female. Median length of stay for the first visit was 4.1 hours, and 2.2 hours for the return visit. Most common ultrasound scans performed were abdomen and pelvis/gyne (34.7%), complete abdomen (30.0%), duplex extremity venous (10.0%). Most common indications on the ultrasound requisition were nonspecific abdominal pain (18.7%), vaginal bleeding with or without pregnancy (17.3%), and hepatobiliary pathology (15.3%). Ultrasounds results reported a relevant finding 56% of the time, and 34% were completely normal. After the next-day ultrasound 5.3% of patients had a CT scan, 10.7% had specialist consultation, 8.2% were admitted, and 7.3% underwent surgery. Conclusion: Information was gathered to close gaps in knowledge about the use of next-day ultrasounds from the ED. A large proportion of patients are discharged home without further interventions. Additional research and the development of next-day ultrasound guidelines or outpatient pathways may improve patient care and ED resource utilization.

scholarly journals Canadian Emergency Department Triage and Acuity Scale (CTAS): Rural Implementation Statement

CJEM ◽  
2003 ◽  
Vol 5 (02) ◽  
pp. 104-107 ◽  
Author(s):  
Keyword(s):  
Emergency Department ◽  
Adverse Effects ◽  
Patient Care ◽  
Emergency Departments ◽  
Improve Patient Care ◽  
Emergency Department Triage ◽  
Improve Patient

BACKGROUND The Canadian Emergency Department Triage and Acuity Scale (CTAS) has been recognized as a significant improvement in standardizing triage in Canadian emergency departments (EDs), both urban and rural. Since its publication an increasing number of Canadian EDs have implemented the CTAS. It was intended to improve patient care through more appropriate triaging of patients, but a number of adverse effects from its implementation have been encountered in rural EDs.

Emergency department observation beds improve patient care: Society for academic emergency medicine debate

1992 ◽  
Vol 21 (8) ◽  
pp. 967-975 ◽  
Author(s):  
Louis Graff ◽  
Leslie S Zun ◽  
Jerrold Leikin ◽  
Brian Gibler ◽  
Michael S Weinstock ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Patient Care ◽  
Improve Patient Care ◽  
Care Society ◽  
Improve Patient

scholarly journals Patients' Attitudes and Prior Treatments in Neuropathic Pain: A Pilot Study

2002 ◽  
Vol 7 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Ian Gilron ◽  
Joan Bailey ◽  
Donald F Weaver ◽  
Robyn L Houlden
Keyword(s):  
Neuropathic Pain ◽  
Pain Management ◽  
Patient Care ◽  
Pain Control ◽  
Tricyclic Antidepressants ◽  
Improve Patient Care ◽  
Ongoing Research ◽  
Pain Duration ◽  
The Mean ◽  
Improve Patient

BACKGROUND:Ongoing research continues to expand the knowledge of neuropathic pain. It is vital that established treatments and valuable discoveries ultimately improve patient care.OBJECTIVES:Attitudes and prior treatments of patients being screened for neuropathic pain trials were evaluated to provide further understanding of the barriers to the management of neuropathic pain.METHODS:A questionnaire was completed by patients with neuropathic pain who were either referred by local physicians or self referred in response to clinical trial advertisements from the authors' facility.RESULTS:In total, 151 patients completed the questionnaire. Diagnoses included diabetic neuropathy (55.6%), postherpetic neuralgia (29.8%), idiopathic peripheral neuropathy (9.3%) and others (5.3%). The mean pain duration was 4.7 years, and the mean daily pain (on a score of 0 to 10) was 7.6. During questioning, 72.8% complained of inadequate pain control and 25.2% had never tried any antineuropathic analgesics (tricyclic antidepressants, opioids or anticonvulsants). New antineuropathic analgesics (eg, gabapentin) were being used by only 16.6%. Opioids, tricyclic antidepressants and anticonvulsants had never been tried by 41.1%, 59.6% and 72.2%, respectively. Fears of addiction and adverse effects were expressed by 31.8% and 48.3%, respectively.CONCLUSIONS:New, and even conventional, therapies are often not pursued, despite inadequate pain control. Several issues are discussed, including patient barriers to seeking pain management, patient and physician barriers to analgesic drug therapy, and appropriate use of and access to multidisciplinary pain centres. Failure to implement therapeutic advances in pain management not only hinders improvement in patient care, but also may render futile decades of research. Widespread professional, patient and public education, as well as continued interdisciplinary research on treatment barriers, is essential.

scholarly journals Identifying avoidable switchboard delays in England’s NHS hospitals: phase one of the national SWITCH project

2019 ◽  
Vol 18 (4) ◽  
pp. 210-215
Author(s):  
Rahul Ghelani ◽  
◽  
Edd Maclean ◽  
Myra Adra ◽  
Sarah Anderson ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Quality Improvement ◽  
Infection Control ◽  
Patient Care ◽  
Improve Patient Care ◽  
Acute Hospital ◽  
Mean Delay ◽  
The Mean ◽  
Hospital Communication ◽  
Improve Patient

Background: Inter-hospital communication frequently requires mediation via a switchboard. Identifying and eliminating switchboard inefficiencies may improve patient care. Methods: All 175 acute hospital switchboards in England were contacted six times. Call contents and duration were recorded. No clinician calls or bleeps were connected. Results: The mean delay before contacting a switchboard operative was 55±46 seconds. 115 hospitals (66%) used automated switchboards; 34 of these (30%) had infection control messages. Robot operators introduced an additional 40 second delay versus humans (mean 70.3±28 versus 29.8±23 seconds, p<0.0001). Multivariate analysis identified robot operators (HR 5.1, p<0.0001) and infection control messages (HR 2.9, p=0.003) as predictors of delays over 60 seconds. Conclusions: There are significant avoidable delays in contacting switchboard operatives across England. Quality improvement is underway.

Sign in / Sign up

Export Citation Format

Share Document