Difference in time to x ray with similar time to treatment decision leads to differences in waiting times of patients with hip fracture in a crowded emergency department

2008 ◽  
Vol 25 (5) ◽  
pp. 274-275 ◽  
Author(s):  
W-T Chia ◽  
Y-S Chen ◽  
C-F J Lin ◽  
H-H Liu ◽  
B-F Lin
Keyword(s):  
Emergency Department ◽  
Hip Fracture ◽  
Waiting Times ◽  
Treatment Decision ◽  
Similar Time ◽  
Time To Treatment ◽  
X Ray

scholarly journals Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110114
Author(s):  
Andrew Nyce ◽  
Snehal Gandhi ◽  
Brian Freeze ◽  
Joshua Bosire ◽  
Terry Ricca ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Experience ◽  
Waiting Times ◽  
Hospital Length ◽  
Short Length ◽  
Hospital Length Of Stay ◽  
Patient’S Experience ◽  
Discharged Patients ◽  
The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

scholarly journals A simple cognitive task intervention to prevent intrusive memories after trauma in patients in the Emergency Department: A randomized controlled trial terminated due to COVID-19

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Marie Kanstrup ◽  
Laura Singh ◽  
Katarina E. Göransson ◽  
Beau Gamble ◽  
Rod S. Taylor ◽  
...  
Keyword(s):  
Emergency Department ◽  
Traumatic Event ◽  
Cognitive Task ◽  
Controlled Trial ◽  
Virus Transmission ◽  
Computer Game ◽  
Similar Time ◽  
Intrusive Memories ◽  
Randomised Controlled ◽  
Simple Cognitive Task

Abstract Objective This randomised controlled trial (RCT) aimed to investigate the effects of a simple cognitive task intervention on intrusive memories ("flashbacks") and associated symptoms following a traumatic event. Patients presenting to a Swedish emergency department (ED) soon after a traumatic event were randomly allocated (1:1) to the simple cognitive task intervention (memory cue + mental rotation instructions + computer game "Tetris" for at least 20 min) or control (podcast, similar time). We planned follow-ups at one-week, 1-month, and where possible, 3- and 6-months post-trauma. Anticipated enrolment was N = 148. Results The RCT was terminated prematurely after recruiting N = 16 participants. The COVID-19 pandemic prevented recruitment/testing in the ED because: (i) the study required face-to-face contact between participants, psychology researchers, ED staff, and patients, incurring risk of virus transmission; (ii) the host ED site received COVID-19 patients; and (iii) reduced flow of patients otherwise presenting to the ED in non-pandemic conditions (e.g. after trauma). We report on delivery of study procedures, recruitment, treatment adherence, outcome completion (primary outcome: number of intrusive memories during week 5), attrition, and limitations. The information presented and limitations may enable our group and others to learn from this terminated study. Trial registration ClinicalTrials.gov: NCT04185155 (04-12-2019)

Does a Dedicated Pediatric Team Within a Busy Mixed Emergency Department Make a Difference in Waiting Times, Satisfaction, and Care Transition?

2010 ◽  
Vol 26 (4) ◽  
pp. 274-280 ◽  
Author(s):  
Gerben Keijzers ◽  
Julia Crilly ◽  
Benjamin Walters ◽  
Rosalind Crawford ◽  
Christa Bell
Keyword(s):  
Emergency Department ◽  
Waiting Times ◽  
Care Transition

scholarly journals Correction to: Chest x-ray severity score in COVID-19 patients on emergency department admission: a two-centre study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Cristian Giuseppe Monaco ◽  
Federico Zaottini ◽  
Simone Schiaffino ◽  
Alessandro Villa ◽  
Gianmarco Della Pepa ◽  
...  
Keyword(s):  
Emergency Department ◽  
Severity Score ◽  
X Ray ◽  
Emergency Department Admission ◽  
Centre Study ◽  
Chest X Ray

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals 113 Improving Intravenous Fluid Therapy to Reduce the Incidence of Acute Kidney Injury in Elderly Hip Fracture Patients

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C McCann ◽  
A Hall ◽  
J Min Leow ◽  
A Harris ◽  
N Hafiz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Kidney Injury ◽  
Hip Fracture ◽  
Length Of Stay ◽  
Kidney Injury ◽  
Ward Round ◽  
Fluid Administration ◽  
Ward Staff ◽  
Intravenous Fluid Therapy ◽  
Significant Difference

Abstract Background Acute kidney injury (AKI) in hip fracture patients is associated with morbidity, mortality, and increased length of stay. To avoid this our unit policy recommends maintenance crystalloid IV fluids of &gt;62.5 mL/Hr for hip fracture patients. However, audits have shown that many patients still receive inadequate IV fluids. Methods Three prospective audits, each including 100 consecutive acute hip fracture patients aged &gt;55, were completed with interventional measures employed between each cycle. Data collection points included details of IV fluid administration and pre/post-operative presence of AKI. Interventions between cycles included a revised checklist for admissions with a structured ward round tool for post-take ward round and various educational measures for Emergency Department, nursing and admitting team staff with dissemination of infographic posters, respectively. Results Cycle 1: 64/100 (64%) patients received adequate fluids. No significant difference in developing AKI post operatively was seen in patients given adequate fluids (2/64, 3.1%) compared to inadequate fluids (4/36, 11.1%; p = 0.107). More patients with pre-operative AKI demonstrated resolution of AKI with appropriate fluid prescription (5/6, 83.3%, vs 0/4, 0%, p &lt; 0.05) Cycle 2: Fewer patients were prescribed adequate fluids (54/100, 54%). There was no significant difference in terms of developing AKI post operatively between patients with adequate fluids (4/54, 7.4%) or inadequate fluids (2/46, 4.3%; p = 0.52). Resolution of pre-operative AKI was similar in patients with adequate or inadequate fluid administration (4/6, 67% vs 2/2, 100%). Cycle 3: More patients received adequate fluids (79/100, 79%, p &lt; 0.05). Patients prescribed adequate fluids were less likely to develop post-operative AKI than those receiving inadequate fluids (2/79, 2.5% vs 3/21, 14.3%; p &lt; 0.05). Discussion This audit demonstrates the importance of administering appropriate IV fluid in hip fracture patients to avoid AKI. Improving coordination with Emergency Department and ward nursing/medical ward staff was a critical step in improving our unit’s adherence to policy.

An investigation into the extent of Lodox imaging usage in South Africa: Radiographer’s perspective

2021 ◽  
Author(s):  
Julius Muchui Thambura ◽  
Jeanette G.E du Plessis ◽  
Cheryl M E McCrindle ◽  
Tanita Cronje
Keyword(s):  
South Africa ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Trauma Patients ◽  
X Rays ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Imaging Protocol ◽  
X Ray ◽  
X Ray Imaging

Abstract Introduction Anecdotal evidence suggests that medical professionals in trauma units are requesting additional regional images using conventional x-ray systems, even after trauma patients have undergone full-body Lodox scans. Patients are then exposed to additional radiation, additional waiting times and an increased medical bill. This study aimed at investigating the extent to which Lodox systems were used in trauma units (n=28) in South Africa. Method In this descriptive cross-sectional study, the researcher invited one radiographer from the 28 hospitals in South Africa that use Lodox systems. Radiographers who were most experienced in using the Lodox system completed an online questionnaire. Results Twenty (71.43% n=20) out of twenty-eight radiographers responded. Most hospitals (90%, n=18) were referring patients for additional conventional x-ray images. Radiographers indicated that conventional x-rays were requested for the chest (27.80%, 10/36), the abdomen (16.67%, 6/36), the spine (13.89%, 5/36) and the extremities and skull (19.44%, 7/36). Additionally, radiographers reported using Lodox to perform procedures and examinations usually performed on conventional x-ray systems when conventional x-ray systems were not operational. Conclusion Currently, it is not clear if the use of conventional x-ray imaging following Lodox is necessary, but the results suggest that the practice is commonplace, with healthcare workers in most hospitals (90%, n=18) requesting additional x-ray imaging. The researcher thus recommends that an imaging protocol for Lodox imaging systems should be developed to guide the referral of the patients for further imaging.

Validating the primary provider theory in emergency medicine

2008 ◽  
Vol 21 (2) ◽  
pp. 120-130 ◽  
Author(s):  
Joseph S. Guarisco ◽  
Stefoni A. Bavin
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Pay For Performance ◽  
Medical Center ◽  
Waiting Times ◽  
Emergency Department Visits ◽  
Business Success ◽  
Content Type ◽  
The Impact

PurposeThe purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.Design/methodology/approachThe case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.FindingsThe findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.Practical implicationsThese findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.Originality/valueThere are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

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