A consensus-based process to define standard national data elements for a canadian emergency department information system

CJEM ◽  
2001 ◽  
Vol 3 (04) ◽  
pp. 277-283 ◽  
Author(s):  
◽  
Grant Innes ◽  
Michael Murray ◽  
Eric Grafstein

Abstract Canadian hospitals gather few emergency department (ED) data, and most cannot track their case mix, care processes, utilization or outcomes. A standard national ED data set would enhance clinical care, quality improvement and research at a local, regional and national level. The Canadian Association of Emergency Physicians, the National Emergency Nurses Affiliation and l’Association des médecins d’urgence du Québec established a joint working group whose objective was to develop a standard national ED data set that meets the information needs of Canadian EDs. The working group reviewed data elements derived from Australia’s Victorian Emergency Minimum Dataset, the US Data Elements for Emergency Department Systems document, the Ontario Hospital Emergency Department Working Group data set and the Canadian Institute for Health Information’s National Ambulatory Care Reporting System data set. By consensus, the group defined each element as mandatory, preferred or optional, and modified data definitions to increase their relevance to the ED context. The working group identified 69 mandatory elements, 5 preferred elements and 29 optional elements representing demographic, process, clinical and utilization measures. The Canadian Emergency Department Information System data set is a feasible, relevant ED data set developed by emergency physicians and nurses and tailored to the needs of Canadian EDs. If widely adopted, it represents an important step toward a national ED information system that will enable regional, provincial and national comparisons and enhance clinical care, quality improvement and research applications in both rural and urban settings.

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S85-S85
Author(s):  
D. K. Klemmer ◽  
C. Ziebel ◽  
N. Sharif ◽  
S. Grubb ◽  
S. Sookram

Introduction: Prior to opening Strathcona Community Hospital (STCH) site leadership were tasked to develop an innovative care model. The central aim was quality improvement and patient safety optimization in the emergency department (ED) utilizing a nurse practitioner (NP) model. They developed 3 pillars: collaboration, multidisciplinary approach, and integration with the plan of improving patient satisfaction and ensuring no patient gets lost to follow up. NPs work in the STCH ED and the NP led Emergency Department Transition (EDT) Clinic in Ambulatory Care. In the ED NPs provide direct clinical care, judicious review of DI and microbiology reports, and care coordination for patients at risk of lost to follow up. The EDT clinic is an innovative NP lead clinic with the purpose of providing timely, high-quality follow up care for ED patients. Methods: Data for the service delivery indicators came from data repository and manual data collection looking at the following outcomes: timely review of DI/micro results; decreased ED visits for non-urgent/emergent issues; safe transitions in care and improved patient satisfaction. Quantitative data from service delivery, patient and surveys were analyzed using Microsoft Excel and SPSS 19. Results: From June 2016 to January 2017 ED NPs at STCH reviewed 3000 positive microbiology reports and made 517 f/u calls to those patients, and reviewed 3181 DI results. This has freed up approximately 2 hrs per day of ED physician time. When NPs were working in the ED, the number of patients who left without treatment (LWT) was approximately 50% less, and improved STCH ED wait times to be among the lowest in the Edmonton Zone. From June 2016 to January 2017, EDT NPs completed 837 patient visits; 371 letters to family physicians (FPs); 215 referrals; and connected 520 patients to a new FP. Patient satisfaction survey show 88-90% of the patients were satisfied with their care. Conclusion: NPs are integral members of the ED team at STCH, providing direct clinical care and several valuable follow up services for ED patients. The EDT clinic provides urgent follow up for ED patients unable to get a timely appointment with their FP or no access to primary care. The clinic also prevents unnecessary returns to ED, and aids to bridge ED services to family physicians or specialist. NPs are the common thread through all departments at STCH, contributing to quality improvement and high patient satisfaction.


CJEM ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Paul Olszynski ◽  
Dan Kim ◽  
Jordan Chenkin ◽  
Louise Rang

Emergency ultrasound (EUS) is now widely considered to be a “skill integral to the practice of emergency medicine.”1The Canadian Association of Emergency Physicians (CAEP) initially issued a position statement in 1999 supporting the availability of focused ultrasound 24 hours per day in the emergency department (ED).2


CJEM ◽  
2004 ◽  
Vol 6 (06) ◽  
pp. 434-440 ◽  
Author(s):  
Edward J. Vargas ◽  
Ameer P. Mody ◽  
Tommy Y. Kim ◽  
T. Kent Denmark ◽  
James A. Moynihan ◽  
...  

ABSTRACT:Objective:There are few reports in the medical literature describing removal of a coin from the upper esophageal tract of a child by an emergency physician. However, given the nature of their training and practice, emergency physicians are well suited to perform this common procedure. We describe our experience with this procedure.Methods:This was a retrospective review of a continuous quality improvement data set from a university-based tertiary care pediatric emergency department between Nov. 1, 2003, and Mar. 31, 2004.Results:Thirteen children, with a median age of 20 months, underwent rapid sequence intubation and had coins successfully removed from their upper esophageal tract by emergency physicians. In 10 cases, the coin was visible at laryngoscopy and removed with Magill forceps. In 3 cases this approach failed and a Foley catheter was used to remove the coin. One child suffered a tonsillar abrasion and two sustained minor lip trauma, but all were extubated and discharged home from the emergency department with no significant complications. Eleven of the 13 patients were successfully followed up, and the parents reported no problems.Conclusions:This pilot study suggests that the removal of a coin from the upper esophageal tract by an emergency physician can be both safe and effective. A larger study is needed before this procedure can be generally recommended.


2010 ◽  
Vol 18 (4) ◽  
pp. 770-777 ◽  
Author(s):  
Mônica Franco Coelho ◽  
Lucieli Dias Pedreschi Chaves ◽  
Maria Luiza Anselmi ◽  
Miyeko Hayashida ◽  
Claudia Benedita dos Santos

Demand for the Emergency Department (ED) has increased, making the organization of work difficult. This quantitative, descriptive and documental study identifies and analyzes the characteristics of clinical care in the ED of a General Hospital in Ribeirão Preto, SP, in 2007, according to organizational variables. The study population included all clinical care consultations registered in the Hospital Management Information System. Data were analyzed through descriptive statistics and discussed considering the theoretical framework of the Single Health System (SUS). A total of 5,285 consultations were registered in the period, which were more frequent in patients from the city itself, in January (10%), on Mondays (16%), from 12pm to 12am (67.1%). The main reason for discharge from the unit was hospitalization (63.8%) and the predominant length of stay in the unit was less than six hours (39.8%). The results support the management of human resources, materials and equipment, indicating the desirability of reorganizing emergency care in the hospital.


2013 ◽  
Vol 25 (4) ◽  
pp. 382-383
Author(s):  
Hideo Tohira ◽  
Judith Finn ◽  
Teresa A Williams ◽  
Daniel M Fatovich ◽  
Ian Jacobs

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S80-S80
Author(s):  
T. Hawkins ◽  
S. K. Dowling ◽  
D. Wang ◽  
A. Mahajan ◽  
A. Mageau ◽  
...  

Introduction: Hypertensive disorders of pregnancy (HDP), including preeclampsia, can develop or worsen in the early postpartum period, often following discharge from hospital, resulting in severe preventable maternal morbidity and mortality. Due to a lack of routine early out-patient follow-up, many women with postpartum HDP present to the emergency department (ED) with severe hypertension or symptoms of preeclampsia (e.g., headache). In the ED, postpartum HDP can be difficult for clinicians to recognize (due to vague presenting symptom) and manage (due to lower blood pressure targets and concern of medication safety). ED clinicians recognized a need for timely recognition and effective treatments for postpartum HDP in the ED to improve maternal outcomes. As such, as part of a multi-step quality improvement initiative, an interdisciplinary team developed and implemented a postpartum HDP management protocol (consisting of nursing and physician protocols and an electronic order set embedded in the electronic medical record). The aims of this specific project were to assess: 1) the use of this clinical management protocol in the ED; and 2) its impacts on clinical care. Methods: This quality improvement project used electronic medical records to identify: 1) ED visits for postpartum HDP for postpartum women ages 20-50; 2) utilization of the postpartum HDP order set; and 3) clinical care outcomes (consultation and admission). Patient population characteristics and clinical care measures were summarized with descriptive statistics and compared using a before and after design. Changes in the utilization of the protocol were assessed using run charts. Results: 540 women with postpartum HDP were seen in the four Calgary EDs in the 16-month period following protocol implementation compared with 335 women in the preceding 12 months. The protocol was used in 46% of these 540 women, and increased over the 16 month follow-up period. We found an increase in the frequency of consultation of specialists (47% to 52%) and admissions (26% to 29%) amongst these women after protocol implementation. Conclusion: This initial assessment demonstrated good uptake of a postpartum HDP management protocol including referral for consultation and admission to hospital for blood pressure management. Future steps include evaluation of the impacts of this management protocol on important patient outcomes.


10.14311/931 ◽  
2008 ◽  
Vol 48 (1) ◽  
Author(s):  
P. Haluzová

This paper describes the application of data mining methods in the database of the DORIS transportation information system, currently used by the Prague Public Transit Company. The goal is to create knowledge about the behavior of objects within this information system. Data is analyzed partly with the help of descriptive statistical methods, and partly with the help of association rules, which may discover common combinations of attributes that occur most frequently within a given data set. Two types of quantifiers were used when creating the association rules; namely “founded implication” and “above average”. The results of the analysis are presented in the form of graphs and hypotheses. 


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