Who Is Next: Patient Prioritization Under Emergency Department Blocking

In “Who Is Next: Patient Prioritization Under Emergency Department Blocking,” Li, Sun, and Hong study how physicians and nurses choose the next patient for treatment in hospital emergency departments (EDs). Using data from a tertiary hospital in Alberta, Canada, they conduct an empirical investigation and find that both clinical factors and resource constraints are considered in patient-prioritization decisions. In particular, discharged patients are prioritized when ED beds are increasingly occupied by boarding patients so as to avoid further blocking the ED. A stylized model is developed to explain the rationale behind the prioritization behavior. Using a simulation study, they show such behavior can improve ED operations by reducing the average patient waiting time and length of stay without adding extra capacity, which results in significant cost savings for hospitals.

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Patient Flow Simulation Using Historically Informed Synthetic Data

Healthier Lives, Digitally Enabled - Studies in Health Technology and Informatics ◽

10.3233/shti210007 ◽

2021 ◽

Author(s):

Ezra Kenny ◽

Hamed Hassanzadeh ◽

Sankalp Khanna ◽

Justin Boyle ◽

Sandra Louise

Keyword(s):

Emergency Department ◽

Simulation Model ◽

Patient Flow ◽

Discrete Event ◽

Synthetic Data ◽

Flow Simulation ◽

Average Patient ◽

Future Demands ◽

Healthcare Administrators ◽

Using Data

Hospital overcrowding is a major problem for healthcare systems around the globe. In order to better estimate future demands and adequate resources for coping with such demands, statistical and computerised modelling can be applied. This can then allow healthcare administrators and decision makers to quantify the impacts of various “what-if” scenarios on hospital performance measures. This paper investigates the application of Discrete Event Simulation towards optimising Emergency Department resources while measuring overall length of stay and queuing time of emergency patients as a target performance measure. In particular, we explore strategies for generating historically informed synthetic data that helps the simulation model track patient flow through the target hospital over a future time frame. Using the developed simulation model, several resource configurations are tested using data from one of the busiest emergency departments in the state of Queensland as the baseline while quantifying the impacts of such changes on key patient flow metrics. It was found that adding a single bed (and associated resources) to the emergency department would result in a 23% decrease in average patient treatment delay.

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Immigration and the tech industry: As a labour shortage remedy, for innovation, or for cost savings?

MIGRATION LETTERS ◽

10.33182/ml.v10i2.144 ◽

2013 ◽

Vol 10 (2) ◽

pp. 201-227 ◽

Cited By ~ 11

Author(s):

Norman Matloff

Keyword(s):

Immigration Policy ◽

Brain Drain ◽

Cost Savings ◽

Foreign Workers ◽

Service Firms ◽

It Service ◽

Labour Shortage ◽

Labour Costs ◽

Using Data ◽

The U.S

The two main reasons cited by the U.S. tech industry for hiring foreign workers--remedying labour shortages and hiring "the best and the brightest"--are investigated, using data on wages, patents, and R&D work, as well as previous research and industry statements. The analysis shows that the claims of shortage and outstanding talent are not supported by the data, even after excluding the Indian IT service firms. Instead, it is shown that the primary goals of employers in hiring foreign workers are to reduce labour costs and to obtain "indentured" employees. Current immigration policy is causing an ‘Internal Brain Drain’ in STEM.

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

Journal of Patient Experience ◽

10.1177/23743735211011404 ◽

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.

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Occupational Sharp Injury and Splash Exposure among Healthcare Workers in a Tertiary Hospital

Journal of Laboratory Physicians ◽

10.1055/s-0041-1731135 ◽

2021 ◽

Author(s):

Roshan Mathew ◽

Ritin Mohindra ◽

Ankit Sahu ◽

Rachana Bhat ◽

Akshaya Ramaswami ◽

...

Keyword(s):

Emergency Department ◽

Hepatitis B ◽

Healthcare Workers ◽

Hepatitis B Surface Antigen ◽

Tertiary Hospital ◽

Needle Stick Injury ◽

Medical Procedures ◽

Immunodeficiency Virus ◽

History Of ◽

Hepatitis C Virus Antibody

Abstract Background Occupational hazards like sharp injury and splash exposure (SISE) are frequently encountered in health-care settings. The adoption of standard precautions by healthcare workers (HCWs) has led to significant reduction in the incidence of such injuries, still SISE continues to pose a serious threat to certain groups of HCWs. Materials and Methods This was a retrospective study which examined the available records of all patients from January 2015 to August 2019 who self-reported to our emergency department with history of sharp injury and/or splash exposure. Details of the patients, mechanism of injury, the circumstances leading to the injury, status of the source (hepatitis B surface antigen, human immunodeficiency virus, and hepatitis C virus antibody status), and the postexposure prophylaxis given were recorded and analyzed. Data were represented in frequency and percentages. Results During the defined period, a total of 834 HCWs reported with SISE, out of which 44.6% were doctors. Majority of the patients have SISE while performing medical procedures on patients (49.5%), while 19.2% were exposed during segregation of waste. The frequency of needle stick injury during cannulation, sampling, and recapping of needle were higher in emergency department than in wards. More than 80% of HCWs received hepatitis B vaccine and immunoglobulin postexposure. Conclusion There is need for periodical briefings on practices of sharp handling as well as re-emphasizing the use of personal protective equipment while performing procedures.

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The Model of Hospital Emergency Departments in 2,000 Bed Hospital in Hungary

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00030557 ◽

1986 ◽

Vol 2 (1-4) ◽

pp. 116-117

Author(s):

Attila Csepanyi ◽

Mihaly Sebestyen

Keyword(s):

Emergency Department ◽

Research Program ◽

Emergency Departments ◽

County Hospital ◽

Hospital Emergency ◽

Ministry Of Health ◽

Ground Floor ◽

Hospital Emergency Departments

The first emergency department in Hungary was established in Hetenyi Geza County Hospital in 1976. It was organized as part of a research program commissioned by the Ministry of Health. Initially, the hospital had 1400 beds which have now increased to 2,000.The Emergency Department is located on the ground floor of a new building and occupies 1,100 square meters of surface. The operation of the department is divided into three main areas.

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Prospective observational study of the practice of endotracheal intubation in the emergency department of a tertiary hospital in Sydney, Australia

Emergency Medicine Australasia ◽

10.1111/1742-6723.12005 ◽

2012 ◽

Vol 24 (6) ◽

pp. 617-624 ◽

Cited By ~ 31

Author(s):

Toby Fogg ◽

Nick Annesley ◽

Kerry Hitos ◽

John Vassiliadis

Keyword(s):

Emergency Department ◽

Observational Study ◽

Endotracheal Intubation ◽

Prospective Observational Study ◽

Tertiary Hospital ◽

Sydney Australia

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Impact of gynecologic hospitalist on patient waiting time at the emergency department in Korea: A retrospective pre-post cohort study

Taiwanese Journal of Obstetrics and Gynecology ◽

10.1016/j.tjog.2021.07.012 ◽

2021 ◽

Vol 60 (5) ◽

pp. 851-856

Author(s):

Ga Won Yim ◽

Soo Jin Park ◽

Eun Ji Lee ◽

Maria Lee ◽

Hyun Hoon Chung ◽

...

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Waiting Time ◽

Patient Waiting Time ◽

Patient Waiting

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A 12-year retrospective analysis of differences between elderly and oldest old patients referred to the emergency department of a large tertiary hospital

Maturitas ◽

10.1016/j.maturitas.2018.11.011 ◽

2019 ◽

Vol 120 ◽

pp. 7-11 ◽

Cited By ~ 6

Author(s):

Marcello Covino ◽

Carmine Petruzziello ◽

Graziano Onder ◽

Alessio Migneco ◽

Benedetta Simeoni ◽

...

Keyword(s):

Emergency Department ◽

Retrospective Analysis ◽

Oldest Old ◽

Tertiary Hospital ◽

Old Patients

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Pediatric Playground-Related Injuries Treated in Hospital Emergency Departments in the United States

Clinical Pediatrics ◽

10.1177/0009922817732144 ◽

2017 ◽

Vol 57 (5) ◽

pp. 584-592 ◽

Cited By ~ 8

Author(s):

Sarah L. Adelson ◽

Thitphalak Chounthirath ◽

Nichole L. Hodges ◽

Christy L. Collins ◽

Gary A. Smith

Keyword(s):

Emergency Departments ◽

Closed Head Injury ◽

Injury Rate ◽

The United States ◽

Injury Surveillance System ◽

Safety Standards ◽

Average Patient ◽

Impact Attenuation ◽

Standards And Guidelines ◽

Hospital Emergency Departments

This study analyzed pediatric playground-related injuries data from the National Electronic Injury Surveillance System. An estimated 5 025 440 children <18 years were treated in US emergency departments for playground-related injuries during 1990-2012, averaging 218 497 children annually. The average patient age was 6.5 years. The overall annual injury rate declined during 1990-2007 ( P < .001) and then increased during 2007-2012 ( P < .001). The climbing equipment–related injury rate remained constant during 1990-2009 and then increased during 2007-2012 ( P = .014). The concussion/closed head injury rate increased during 1990-2008 ( P < .002) with the rate almost doubling from 2008-2012 ( P < .001). Falls accounted for 76.7% of all injuries and 87.7% of injuries to the upper extremities. Injuries resulted in hospitalization for 4.3% of patients. Despite current playground safety standards and guidelines, a large number of playground-related injuries continue to occur. Revised impact attenuation criteria for playground surfacing materials should be implemented and evaluated to more adequately prevent fall-related upper extremity fractures.

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