Survey of the Statewide Impact of Payer Source on Referral of Small Burns to Burn Centers

2017 ◽  
Vol 38 (4) ◽  
pp. e699-e703
Author(s):  
Rachel Penny ◽  
Rebecca Coffey ◽  
Larry Jones ◽  
J. Kevin Bailey
Keyword(s):  
Burn Centers ◽  
Payer Source

Predictive Factors for Patients’ Failure to Show for Initial Outpatient Physical Therapist Evaluation

2021 ◽  
Author(s):  
Matthew Briggs ◽  
Christine Ulses ◽  
Lucas VanEtten ◽  
Cody Mansfield ◽  
Anthony Ganim ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Employment Status ◽  
Physical Therapist ◽  
Demographic Data ◽  
Binary Logistic Regression ◽  
Final Analysis ◽  
Outpatient Setting ◽  
Binary Logistic Regression Model ◽  
Number Of Patients ◽  
Payer Source

Abstract Objective The objective of this study was to xamine primary factors which may predict patients’ failure to show at initial physical therapist evaluation in an orthopedic and sports outpatient setting. Methods A retrospective analysis of patients’ demographic data for physical therapist evaluations between January 2013 and April 2015 was performed. A binary logistic regression model was used to evaluate the odds of a no-show at evaluation. Demographic variables of age, employment status, days waited for the appointment, payer source, and distance traveled to clinic were analyzed. Independent variables were considered significant if the 95% Cis of the odds ratios did not include 1.0. Results A total of 6971 patients were included in the final analysis with 10% (n = 698) of the scheduled patients having a no-show event for their initial evaluation. The following factors increased the odds of patients having a no-show event: days to appointment (OR = 1.058; 95% CI = 1.042 to 1.074), unemployment status (OR = 1.96; 95% CI = 1.41 to 2.73), unknown employment status (OR = 3.22; 95% CI = 1.12 to 8.69), Medicaid insurance (OR = 4.87; 95% CI = 3.43 to 6.93), Medicare insurance (OR = 2.22; 95% CI = 1.10 to 4.49), unknown payer source (OR = 262.84; 95% CI = 188.72 to 366.08), and distance traveled ≥5 miles (OR = 1.31; 95% CI = 1.01 to 1.70). Female sex [OR = 0.73; 95% CI = 0.57 to 0.95) and age ≥ 40 years (OR = 0.44; 95% CI = 0.33 to 0.60) decreased the odds of a no-show event. Conclusion Results from this study indicate there may be some demographic factors that are predictive of patients failing to attend their first physical therapist visit. Impact Understanding the predictive factors and identifying potential opportunities for improvements in scheduling processes might help decrease the number of patients failing to show for their initial physical therapy appointment, with the ultimate goal of positively influencing patient outcomes.

79 Electronic Cigarette-Related Injuries Presenting to Five Large Burn Centers, 2015–2019

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S54-S55
Author(s):  
Carmen E Flores ◽  
Paul J Chestovich ◽  
Syed F Saquib ◽  
Joseph T Carroll ◽  
Mariam Al-Hamad Daubs ◽  
...  
Keyword(s):  
Thermal Injury ◽  
Spontaneous Combustion ◽  
Electronic Cigarettes ◽  
Total Body Surface Area ◽  
Public Health Problem ◽  
Electronic Cigarette ◽  
Outpatient Basis ◽  
Burn Centers ◽  
Split Thickness Skin Grafting ◽  
Inpatient Basis

Abstract Introduction Electronic cigarettes are advertised as safer alternatives to smoking cigarettes yet can cause serious injury. As consumer use of electronic cigarettes has increased, burn centers have witnessed a rise in both inpatient and outpatient visits to treat thermal and blast injuries related to their use. Methods A multicenter retrospective chart review of ABA burn registry data from 5 large burn centers was performed from January 2015 to July 2019 to identify patients who sustained Electronic Nicotine Delivery Systems (ENDS)-related injuries. Results A total of 127 patients with electronic cigarette-related injuries were identified, of which 113 were male (89%) and 14 were female (11%). Mean age was 34.0 years (SD 13.5%, range 1–75 years). The majority of patients (n=92, 72%) were treated on an inpatient basis, and average length of stay was 6.7 days. Most patients sustained less than 10% total body surface area burns (mean 3.8%, SD 2.6%, range 0.1% to 16.5%). 66% (n=85) sustained 2nd degree burns, and 36% (n=46) sustained 3rd degree burns. Most patients were injured while using the ENDS (n=100, 78%), while 18% (n=24) of patients reported spontaneous combustion. 2 patients (1.5%) were injured while changing their device battery, and 2 patients (1.5%) were injured while modifying the device. 3% (n=4) were injured by second-hand mechanism. Burn injury was the most common injury pattern (100%), followed by blast injury (n=81, 63%). Flame burns were the most common (n=89, 70%) type of thermal injury, followed by contact burns (n= 70, 55%), flash burns (n=47, 37%), chemical burns (n=2, 1.5%), and electrical burns (n=1, 0.7%). The most commonly injured body region was the extremities. There were no ENDS-related deaths. Silvadene was the most common topical agent used in the initial management of thermal injuries, followed by Bacitracin and Xeroform. 63% (n=80) of patients did not require surgery, while 36% (n=46) required surgical excision, and 15% (n=20) required split-thickness skin grafting. Multiple surgeries were uncommon. 22% of patients required one operation, 12% required two operations, and 2% required 3 operations. Conclusions Our data recognizes use of ENDS as a growing public health problem with potential to cause thermal injury and secondary trauma. Most injuries occur during use, however many result from spontaneous combustion while the device is not being used. Treatment of ENDS-related injuries is institution-dependent. Most patients are treated on an inpatient basis however the majority of patients treated on outpatient basis have good outcomes.

Allograft Skin Availability: A Survey of Burn Centers and Tissue Banks

2002 ◽  
Vol 23 ◽  
pp. S48
Author(s):  
R. J. Kagan ◽  
E. Robb ◽  
R. Plessinger ◽  
G. Greenleaf ◽  
J. Pierce ◽  
...  
Keyword(s):  
Tissue Banks ◽  
Burn Centers

scholarly journals 47 COVID-19 Impact on Burn Care- A Summary of Weekly Bed Counts and Surge Capacity

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S35-S35
Author(s):  
Jeffrey E Carter ◽  
Herbert Phelan ◽  
Colleen M Ryan ◽  
James C Jeng ◽  
Kathryn Mai ◽  
...  
Keyword(s):  
Substantial Reduction ◽  
Surge Capacity ◽  
Burn Centers ◽  
Resource Limitations ◽  
Burn Care ◽  
Regional Trends ◽  
Number Of Patients ◽  
Bed Capacity ◽  
Initial Survey ◽  
The Impact

Abstract Introduction The COVID-19 pandemic has raised global awareness of healthcare resource limitations. Specifically, the pandemic has demonstrated that burn disaster planning should involve non-burn disasters that threaten staff, supplies, or space. The ABA facilitated bed counts with the assistance of regional disaster coordinators from April through August of 2020. Our analysis examines the impact of the pandemic on burn surge and bed capacity in the U.S. Methods Bed availability was obtained by the ABA regional disaster coordinators through an initiative by the Organization and Delivery of Burn Care Committee. Bed availability was defined as immediately available burn beds and categorized as adult, pediatric, or flexible. Surge capacity was defined as the maximum number of patients that a burn center could admit in a surge situation. Data was deidentified by the central office with descriptive statistics to determine bed availability and surge capacity trends regionally and nationally. Results Bed counts were performed 6 times from 04/17/2020 through 08/14/2020. Response rates from the 137 North American burn centers varied from 86–96%. At least 6 burn centers (5%) were either closed or converted for COVID patients during the initial two bed counts. The total number of adult or pediatric burn beds was 2,082. Total bed availability decreased from 845 at the first survey down to 572 beds at the last survey. Surge capacity baseline was 1,668 beds and decreased from 1,132 beds in the initial survey down to 833 beds in the final survey. Conclusions Our study demonstrates a significant impact on burn bed availability due to the COVID-19 pandemic with a 37% reduction in available burn beds from April to August and a 26% reduction in surge capacity. This study demonstrates a substantial reduction in bed availability during the pandemic with additional analysis in process to examine regional trends.

100 Use of the PHQ-2 as a Depression Screening Tool to Meet BQUIP Guidelines

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S68-S68
Author(s):  
Eva Keatley ◽  
Carolyn B Blayney ◽  
Shelley A Wiechman
Keyword(s):  
Depressive Symptoms ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Nursing Staff ◽  
Burn Injury ◽  
Improvement Program ◽  
Systematic Screening ◽  
Positive Screen ◽  
Burn Centers ◽  
Task List

Abstract Introduction In 2015, the Burn Quality Improvement Program (BQUIP) guidelines were established with recommendations for systematic screening of Major Depressive Disorder at all verified burn centers. Our level one trauma center rolled out a program to screen all patients entering the burn service starting in June 2018. After a year of collecting data, we have been able to evaluate the program and make recommendations for other burn centers. Methods All patients admitted to the inpatient burn service who were over 12 years of age were screened by bedside nurses using the 2-item Patient Health Questionnaire (PHQ-2). Exclusion for screening included those who were intubated and sedated and/or not alert or oriented. A reminder automatically popped up in the nursing task list in the electronic medical record until it was given, or patient was coded as not appropriate for screening. Results A total of 509 patients were admitted to the Burn Service between June 2018 and May 2019. Of those, 40 were identified as not being appropriate for screening due to inability to regain consciousness, and 116 (24%) were not screened for unknown reasons. The remaining patients, 353 (77%) were screened with the PHQ-2 and 94% of these patients were screened on the same day of admit. Of the patients screened, 28 (8%) scored above the clinical cut-off for probable depression (PHQ-2 ³ 3) and 265 (75.1%) did not endorse any symptoms on the PHQ-2. Of the 28 that screened positive, 16 (57.1%) received psychological services. Of those that did not receive psychology services, the majority were admitted for less than 3 days (n=10, 76.9%). Conclusions In the first year of the program the vast majority of eligible patients were able to be screened by nursing staff with a 2-item measure. A 77% screening rate is high for a trauma setting. This success is likely due to the automation of the task in the electronic medical record, the ease of use of the PHQ-2 and the dedication of the nursing staff. The 8% rate of a positive screen is higher than the general population (4%) but a similar rate to what is reported in the literature of burn survivors who are 5- and 10-years post burn injury. Given that most patients were screened within 24 hours of admission, we are capturing depressive symptoms that predate the injury. We know that depression can impair burn recovery (e.g., affect participation in therapy, impede wound healing) and lead to poorer long-term outcomes. Systematic screening of depressive symptoms upon admission will allow us to intervene earlier and potentially reduce barriers to optimal recovery. We will be discussing utilization of resources for providing inpatient services to patients with a positive screen.

TRANSPORTING BURN PATIENTS TO REGIONAL BURN CENTERS

2007 ◽  
Vol 107 (7) ◽  
pp. 72DD
Author(s):  
Christine Cutugno ◽  
Julie Chu ◽  
Andrea Kayyali
Keyword(s):  
Burn Patients ◽  
Burn Centers

scholarly journals A Survey of Temperature Management Practices Among Burn Centers in North America

2017 ◽  
Vol 39 (4) ◽  
pp. 612-617 ◽  
Author(s):  
Kaitlin A Pruskowski ◽  
Julie A Rizzo ◽  
Beth A Shields ◽  
Rodney K Chan ◽  
Ian R Driscoll ◽  
...  
Keyword(s):  
North America ◽  
Management Practices ◽  
Temperature Management ◽  
Burn Centers

Electronic Cigarette-Related Injuries Presenting to Five Large Burn Centers, 2015-2019

2021 ◽  
Author(s):  
Carmen E Flores ◽  
Paul J Chestovich ◽  
Syed Saquib ◽  
Joseph Carroll ◽  
Mariam Al-Hamad ◽  
...  
Keyword(s):  
Thermal Injury ◽  
Burn Injury ◽  
Electronic Cigarettes ◽  
Total Body Surface Area ◽  
Public Health Problem ◽  
Electronic Cigarette ◽  
Body Region ◽  
Outpatient Basis ◽  
Burn Centers ◽  
Thermal Injuries

Abstract Electronic cigarettes are advertised as safer alternatives to traditional cigarettes yet cause serious injury. US burn centers have witnessed a rise in both inpatient and outpatient visits to treat thermal injuries related to their use. A multicenter retrospective chart review of American Burn Association burn registry data from 5 large burn centers was performed from January 2015 to July 2019 to identify patients with electronic cigarette-related injuries. A total of 127 patients were identified. Most sustained less than 10% total body surface area burns (mean 3.8%). Sixty-six percent sustained 2nd degree burns. Most patients (78%) were injured while using their device. Eighteen percent of patients reported spontaneous device combustion. Two patients were injured while changing their device battery, and two were injured modifying their device. Three percent were injured by second-hand mechanism. Burn injury was the most common injury pattern (100%), followed by blast injury (3.93%). Flame burns were the most common (70%) type of thermal injury; however, most patients sustained a combination-type injury secondary to multiple burn mechanisms. The most injured body region was the extremities. Silver sulfadiazine was the most common agent used in initial management of thermal injuries. Sixty-three percent of patients did not require surgery. Of the 36% requiring surgery, 43.4% required skin grafting. Multiple surgeries were uncommon. Our data recognizes electronic cigarette use as a public health problem with potential to cause thermal injury and secondary trauma. Most patients are treated on an inpatient basis although most patients treated on outpatient basis have good outcomes.

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