scholarly journals Return Visit Admissions May Not Indicate Quality of Emergency Department Care for Children

2017 ◽  
Vol 25 (3) ◽  
pp. 283-292 ◽  
Author(s):  
Marion R. Sills ◽  
Michelle L. Macy ◽  
Keith E. Kocher ◽  
Amber K. Sabbatini
Keyword(s):  
Emergency Department ◽  
Emergency Department Care ◽  
Return Visit

scholarly journals National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Akshay Pendyal ◽  
Craig Rothenberg ◽  
Jean E. Scofi ◽  
Harlan M. Krumholz ◽  
Basmah Safdar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Length Of Stay ◽  
Real World ◽  
The United States ◽  
Emergency Department Care ◽  
Care Processes ◽  
Ed Visits

Background Despite investments to improve quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real‐world trends in AMI care in the emergency department (ED). We aimed to describe trends in the epidemiology and quality of AMI care in US EDs over a recent 11‐year period, from 2005 to 2015. Methods and Results We conducted an observational study of ED visits for AMI using the National Hospital Ambulatory Medical Care Survey, a nationally representative probability sample of US EDs. AMI visits were classified as ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI. Outcomes included annual incidence of AMI, median ED length of stay, ED disposition type, and ED administration of evidence‐based medications. Annual ED visits for AMI decreased from 1 493 145 in 2005 to 581 924 in 2015. Estimated yearly incidence of ED visits for STEMI decreased from 1 402 768 to 315 813. The proportion of STEMI sent for immediate, same‐hospital catheterization increased from 12% to 37%. Among patients with STEMI sent directly for catheterization, median ED length of stay decreased from 62 to 37 minutes. ED administration of antithrombotic and nonaspirin antiplatelet agents rose for STEMI (23%–31% and 10%–27%, respectively). Conclusions National, real‐world trends in the epidemiology of AMI in the ED parallel those of clinical registries, with decreases in AMI incidence and STEMI proportion. ED care processes for STEMI mirror evolving guidelines that favor high‐intensity antiplatelet therapy, early invasive strategies, and regionalization of care.

scholarly journals Improved Accuracy and Quality of Information During Emergency Department Care Transitions

2017 ◽  
Vol 18 (3) ◽  
pp. 459-465 ◽  
Author(s):  
Nnaemeka Okafor ◽  
Justin Mazzillo ◽  
Sara Miller ◽  
Kimberly Chambers ◽  
Samar Yusuf ◽  
...  
Keyword(s):  
Emergency Department ◽  
Care Transitions ◽  
Quality Of Information ◽  
Emergency Department Care ◽  
Improved Accuracy

Patient sex and quality of emergency department care for patients with acute myocardial infarction

2004 ◽  
Vol 44 (4) ◽  
pp. S133-S134
Author(s):  
D.R. Vinson ◽  
D.J. Magid ◽  
T.G. Padgett ◽  
T.M. Vlugt ◽  
A.S. Go ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Emergency Department Care

Development of Measures of the Quality of Emergency Department Care for Children Using a Structured Panel Process

PEDIATRICS ◽  
2006 ◽  
Vol 118 (1) ◽  
pp. 114-123 ◽  
Author(s):  
A. Guttmann ◽  
A. Razzaq ◽  
P. Lindsay ◽  
B. Zagorski ◽  
G. M. Anderson
Keyword(s):  
Emergency Department ◽  
Emergency Department Care

scholarly journals Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people

2008 ◽  
Vol 32 (4) ◽  
pp. 648 ◽  
Author(s):  
David P Thomas ◽  
Ian P Anderson ◽  
Margaret A Kelaher
Keyword(s):  
Emergency Department ◽  
Quality Of Care ◽  
Indigenous People ◽  
Emergency Departments ◽  
Torres Strait Islander ◽  
Torres Strait Islander People ◽  
Similar Time ◽  
Emergency Department Care ◽  
Torres Strait

Objectives: To examine the accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people compared with other Australians. Methods: We examined 2004?05 data from the National Non-admitted Patient Emergency Department Care database from the Northern Territory and Western Australia, the only jurisdictions where Indigenous identification in the database was considered acceptable. Results: In the NT, Indigenous people were 1.7 times as likely to present to an emergency department as non-Indigenous people. Indigenous patients in the NT and WA do not appear to use EDs for ?primary care? problems more than non- Indigenous patients. More NT Indigenous patients walked out before being seen or before their treatment was completed. However, Indigenous patients generally waited a similar time, and often slightly shorter, to be seen as similar non-Indigenous patients in WA and the NT. Conclusions: We recommend the regular monitoring of equity in the accessibility and quality of ED care for Indigenous people compared with other Australians. Indigenous identification in the database needs to improve so monitoring of ED performance can extend beyond WA and the NT.

A systematic review examining the impact of redirecting low-acuity patients seeking emergency department care: is the juice worth the squeeze?

2018 ◽  
pp. emermed-2017-207045 ◽  
Author(s):  
Scott William Kirkland ◽  
Amir Soleimani ◽  
Brian H Rowe ◽  
Amanda S Newton
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Grey Literature ◽  
Healthcare Utilisation ◽  
Conclusive Evidence ◽  
Emergency Department Care ◽  
Significant Difference ◽  
Hospital Diversion ◽  
The Impact

ObjectivesDiverting patients away from the emergency department (ED) has been proposed as a solution for mitigating overcrowding. This systematic review examined the impact of interventions designed to either bypass the ED or direct patients to other alternative care after ED presentation.MethodsSeven electronic databases and the grey literature were searched. Eligible studies included randomised/controlled trials or cohort studies that assessed the effectiveness of pre-hospital or ED-based diversion interventions. Two reviewers independently screened the studies for relevance, inclusion and risk of bias. Pooled statistics were calculated as relative risks (RR) with 95% confidence intervals (CI) using a random effects model.ResultsFifteen studies were included evaluating pre-hospital (n=11) or ED-based (n=4) diversion interventions. The quality of the studies ranged from moderate to low. Patients deemed suitable for diversion among the pre-hospital studies (n=3) ranged from 19.2% to 90.4% and from 19% to 36% in ED-based studies (n=4). Of the eligible patients, the proportion of patients diverted via ED-based diversion tended to be higher (median 85%; IQR 76–93%) compared with pre-hospital diversion (median 40%; IQR 24–57%). Overall, pre-hospital diversion did not decrease the proportion of patients transferred to the ED compared with standard care (RR 0.92; 95% CI 0.80 to 1.06). There was no significant decrease in subsequent ED utilisation among patients diverted via pre-hospital diversion compared with non-diverted patients (RR 1.09; 95% CI 0.99 to 1.21). Of the three pre-hospital studies completing a cost analysis, none found a significant difference in total healthcare costs between diverted and non-diverted patients.ConclusionThere was no conclusive evidence regarding the impact of diversion strategies on ED utilisation and subsequent healthcare utilisation. The overall quality of the research limited the ability of this review to draw definitive conclusions and more research is required prior to widespread implementation.

scholarly journals Crowding Measures Associated With the Quality of Emergency Department Care: A Systematic Review

2015 ◽  
Vol 22 (6) ◽  
pp. 643-656 ◽  
Author(s):  
Antonia S. Stang ◽  
Jennifer Crotts ◽  
David W. Johnson ◽  
Lisa Hartling ◽  
Astrid Guttmann
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Emergency Department Care
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