Emergency Department Staff Planning to Improve Patient Care and Reduce Costs

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.

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H1N1: Communication Patterns among Emergency Department Staff during the H1N1 Outbreak, April 2009

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00008220 ◽

2010 ◽

Vol 25 (4) ◽

pp. 296-301 ◽

Cited By ~ 1

Author(s):

Kelly R. Klein ◽

Hillary Cohen ◽

Cindy Baseluos ◽

John Marshall ◽

Antonios Likourezos ◽

...

Keyword(s):

Emergency Department ◽

Patient Care ◽

Communication Patterns ◽

Internet Survey ◽

World Health ◽

Care Providers ◽

Emergency Department Staff ◽

Department Staff ◽

The World ◽

H1n1 Outbreak

AbstractIntroduction:The H1N1 influenza virus has been described by the World Health Organization (WHO) and the media as a disease that could rival the 1918 Spanish Influenza epidemic in deaths. During the spring of 2009, emergency departments across the world saw a spike in the number of influenza cases and by June 2009, the WHO had declared H1N1 a pandemic. In order to prevent emergency department staff from becoming ill and to provide upto-date medical care to patients, information had to be disseminated quickly to emergency department staff.Methods:An anonymous Internet survey was utilized to query emergency department staff regarding communication methods and overall attitudes regarding safety and treatment during the spring of 2009.Results:The majority of emergency department staff (263; 88.3%) used multiple sources to obtain information about the H1N1 virus. There were 258 respondents (88.9%) that felt that the hospital was supplying them with the necessary information to protect themselves and their families and 280 (98.5%) felt confident that their emergency department was treating patients by the government-recommended guidelines. Statistically significant differences were noted in communication patterns between direct and indirect patient care providers.Conclusions:In general, H1N1 communication to emergency department staff was perceived as good during the initial H1N1 outbreak. However, because of the limitations associated with an online survey, these results do not allow for generalization to the total emergency department staff population. Hospital administrators may need to consider the differences in communication preferences of direct patient care providers and indirect patient care providers when distributing important information to emergency department staff during crisis and emergency situations.

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

CJEM ◽

10.1017/s1481803500008241 ◽

2003 ◽

Vol 5 (02) ◽

pp. 104-107 ◽

Cited By ~ 3

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.

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