scholarly journals Analysis of the Associated Factors of Boarding Time in Yellow Zone Patients in Emergency Department

Jurnal NERS ◽  
2017 ◽  
Vol 12 (2) ◽  
pp. 261
Author(s):  
Ahsan Ahsan ◽  
Fitrio Deviantony ◽  
Setyoadi Setyoadi
Keyword(s):  
Emergency Department ◽  
Linear Regression ◽  
Emergency Room ◽  
Service Management ◽  
Dominant Factor ◽  
Bivariate Analysis ◽  
Transfer Time ◽  
Coverage Ratio ◽  
Number Of Patients ◽  
Diagnostic Time

Introduction: Patient’s visits to the emergency room increase in number every year. The increasing number of hospital visits is directly associated with the increasing number of patients who wait in the emergency department. The yellow zone is a part of the emergency room that has become a place for the most increased patients to enter. This situation causes boarding time patient longer than usual. The aim of this research was to analyse the various factors that have been associated with boarding time in the yellow zone emergency department. Methods: This research was an analytic observational study with a cross-sectional approach. The number of samples was 78 respondents who were recruited with a non-probability sampling technique. The univariate and bivariate analysis was utilized to test the relationship between the variables. A further statistical test was conducted with linear regression to understand the most dominant factor. Results: The results showed a significant relationship between transfer time, laboratory turnaround time, diagnostic time, time arrival, insurance coverage, ratio nurse and patient and boarding time. Furthermore, multivariate analysis with linear regression showed a significant association between transfer time, laboratory turns around, and the ratio of nurses to patients with the boarding time. Conclusions: The findings from this study show that patient boarding time in the yellow zone should consider several factors. This research provides the output of the initial data as one of the basic considerations for service management and team minimum service standards in hospitals.

scholarly journals ANALYSIS OF FACTORS ASSOCIATED WITH BOARDING TIME IN YELLOW ZONE OF EMERGENCY DEPARTMENT AT dr.ISKAK TULUNGAGUNG HOSPITAL

2017 ◽  
Vol 2 (2) ◽  
pp. 109
Author(s):  
Fitrio Deviantony ◽  
Ahsan Ahsan ◽  
Setyoadi Setyoadi
Keyword(s):  
Emergency Department ◽  
Linear Regression ◽  
Observational Research ◽  
Dominant Factor ◽  
Time Of Arrival ◽  
Cross Sectional ◽  
Laboratory Test Results ◽  
Number Of Patients ◽  
Diagnostic Time ◽  
Spearman Test

Patient’s visits in the emergency room (ER) increase in number in every year. The increasing number of hospital visits is directly associated with the increasing number of patients who come to the emergency department. The increased number of patients resulted in the buildup of patients in the ER, especially in the Yellow Zone and causing the boarding time after the inpatient decision was decided to be longer. The purpose of this study was to analyze the problems related to variables that have a correlation with the boarding time of the patient after the decision of hospitalization is decided in the yellow zone of the emergency department at RSUD dr. Iskak Tulungagung. The method of this research was analytic observational research with cross sectional approach. The number of samples was 78 respondents. The sampling technique used nonprobability sampling. Pearson test and Spearman test were applied to identify the correlation between variables and multivariate linear regression test was used to find out the most dominant factor in influencing patient boarding time after the decision of hospitalization was made. The result of bivariate test showed the correlation between boarding time with room preparation time (p = 0.000), laboratory test results (p = 0.000), diagnostic time (p = 0.000), and ratio between nurse and patient (p = 0.000). Boarding time was not correlated with time of arrival (p = 0.263) and insurance coverage (p = 0.980). Multivariate analysis with linear regression obtained result of constant value (B = 681.212), ratio between nurse and patient (p= 0.000; B = -861.011), bed occupancy time (p= 0.000; B =0.620) and diagnostic time (p=0.022; B = 2.636). The implication of this research is to get a formula that able to shorten patient boarding time after the decision of hospitalization was made and can give a standart time for boarding time.

scholarly journals Impact of the Use of a WhatsApp-based Group Chat for Sharing Emergency Department Access-Block Data on Overcrowding and Census in a Low-Resource Emergency Department in Kigali, Rwanda

2020 ◽  
Author(s):  
Menelas Nkeshimana ◽  
Christine Uwineza ◽  
Amelia Y Pousson ◽  
Giles N Cattermole
Keyword(s):  
Emergency Department ◽  
Emergency Room ◽  
Emergency Evacuation ◽  
Care Process ◽  
Healthcare Provision ◽  
Middle Income ◽  
Middle Income Countries ◽  
Centre Hospitalier Universitaire ◽  
Number Of Patients ◽  
Block Data

AbstractIn Low & Middle Income Countries (LMICs), hospitals often face serious communication issues that threaten to paralyze the process of healthcare provision. The Centre Hospitalier Universitaire de Kigali (CHUK) is located in the middle of a vibrant city of Kigali, and is often overwhelmed by a high number of referred patients from its catchment area, and those brought in by emergency evacuation ambulance system (SAMU). The facility has no interdepartmental landline communication network, which would be ideal to connect the inpatient services to the emergency room in order to fasten the care process. Using WhatsApp-based Group Chat for sharing the real-time caseloads, the number of patients boarding the emergency room has significantly improved (dropping from 38.1 +-7.1 to 28 +-6.5, p<0.001), although the overall length of stay in the emergency room has remained high (3.37 +-0.61 days), mainly due to other co-factors such as the availability of specialized staff (i.e. neurosurgeon) and uninterrupted imaging services (i.e. computer tomography scans).

Assessment of Daily Burden and Factors for Overcrowded Emergency Department at Tertiary Care Hospital of Karachi

2021 ◽  
pp. 30-35
Author(s):  
Arsala Faridi ◽  
Farah Ahmad ◽  
Areej Zehra ◽  
Afreen Fazal
Keyword(s):  
Emergency Department ◽  
Emergency Room ◽  
Tertiary Care Hospital ◽  
Patient Flow ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Duration ◽  
Number Of Patients ◽  
Significant Difference

Background: When in emergency room there is no enough area left to serve or to admit the subsequent sick patients who may require urgent attention and observation the setting is called as the overcrowded emergency room. Due to overcrowded emergency department the quality of services provided by the staff and doctors is compromised ultimately patients with severe diseases are ignored and this may be one of the causes for causalities. Objective: To assess the daily burden and factors responsible for overcrowding at emergency department of tertiary care hospital of Karachi. Methodology: It was a cross sectional study conducted at tertiary care hospital of Karachi from October 2020 to January 2021. Data of patients coming to adult emergency department of either gender were collected.  Patients age <14 were excluded as these were referred to pediatric emergency department. Data collection was done according to Canadian emergency department triage and acuity scale (CTAS). Results: Total number (N) of patients who visited emergency department in study duration was 13434. The mean number of patients who visited ED was 141±13during our study duration. There was no any significant difference in presenting complaint. Delay in investigations was found to be a reason of prolong stay and overcrowding in ED in our setting. Conclusion: Overcrowding of patients in our ED of our setting was a common problem. The number of staff, doctors and beds were not matching the number of patient flow in the department. The main reason of prolong stay in ED was delay in investigations.

scholarly journals Analisis Faktor Yang Berhubungan Dengan Waktu Tanggap Pada Pasien Gawat Darurat Di Instalasi Gawat Darurat (IGD) RSUD A.Wahab Sjahranie Samarinda

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wiyadi Wiyadi ◽  
Gajali Rahman
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Emergency Room ◽  
Univariate Analysis ◽  
Dominant Factor ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Careful Handling ◽  
And Shifts

Emergency Department (ED) is the gateway for entry of patients experiencing emergency department. The services provided by the emergency room are services that require fast, precise and careful handling in determining the emergency priorities of patients to prevent disability and death. The purpose of this research is to analyze the factors related to the response time of emergency patients in ED Hospital A.W Syahranie by using observational or descriptive designs. The design of this study was cross-sectional with accidental sampling method with a sample size of 323 respondents. The results of the study were analyzed univariate, bivariate and multivariate to look for the dominant factor in emergency response time in the emergency room at A.W Syahranie Hospital Samarinda. Univariate analysis looking for percentage and bivariate analyzed with Chi Square test while multivariate with logistic regression. The results obtained P value> 0.05 for factors of payment methods, attendance of staff, staff placement patterns, availability of brankers, and shifts and the value of P <0.05 for factors of patient arrival time, patient priorities, nurse tenure and nurse education level. The conclusion from the multivariate test found that the most dominant factor related to response time was the length of service of the nurse. Keywords: factors, response time

Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

Analisis Faktor Determinan Pelaksanaan Inisiasi Menyusu Dini Oleh Bidan Di Rumah Sakit Umum Anutapura Palu

2018 ◽  
Vol 1 (1) ◽  
pp. 34
Author(s):  
Ni Nyoman Novita ◽  
Gusman Arsyad
Keyword(s):  
Emergency Room ◽  
Peer Support ◽  
Statistical Tests ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Implementation Processes ◽  
Chi Square Test ◽  
The Government

Implementation of IMD in hospitals has decreased from the previous year and has not reached the target set by the government. Some IMD implementation processes have not been carried out according to applicable standards. So that babies do not get an IMD in accordance with existing SOPs. The purpose of this study was to determine the determinant factors associated with the implementation of the IMD by midwives in the Midwifery and Maternity Room Emergency Room (IGD) at the Anutapura General Hospital in Palu. This research method is analytical with cross sectional approach. The population of this study was that all midwives in the obstetrics emergency room and maternity room at Anutapura Palu Hospital were 37 respondents. The sample in this study is total sampling. The analysis used was univariate, and bivariate analysis using the chi square test with a confidence level of 95% (α = 0.05). The results of statistical tests on variable knowledge of midwives with the implementation of IMD p value: 0.018 (p value <0.05). APN training with the implementation of IMD p value: 0.697 (p value> 0.05). length of work with the implementation of IMD p value: 0.029 (p value <0.05). and peer support with the implementation of IMD p value: 0.007 (p value <0.05). Conclusions there is a relationship between knowledge, length of work, peer support with the implementation of the IMD, and training factors that have nothing to do with IMD implementation. The strongest factor in the relationship is peer support. It is recommended that the Anutarapura Palu Hospital be able to motivate midwives so that they can further enhance their role in the implementation and provide support to their colleagues so that the implementation of the IMD can be carried out in accordance with applicable standards.Keywords: Knowledge, APN Training, Duration of work, Implementation of IMD

Development and Performance Assessment of a Digital Serious Game to Assess Multi-Patient Care Skills in a Simulated Pediatric Emergency Department

2020 ◽  
Vol 51 (4) ◽  
pp. 550-570
Author(s):  
Cindy Luu ◽  
Thomas B. Talbot ◽  
Cha Chi Fung ◽  
Eyal Ben-Isaac ◽  
Juan Espinoza ◽  
...  
Keyword(s):  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Patient Care ◽  
Skill Acquisition ◽  
Video Game ◽  
Rank Correlation ◽  
Fixed Time ◽  
Serious Game ◽  
Cross Sectional ◽  
Number Of Patients

Objective. Multi-patient care is important among medical trainees in an emergency department (ED). While resident efficiency is a typically measured metric, multi-patient care involves both efficiency and diagnostic / treatment accuracy. Multi-patient care ability is difficult to assess, though simulation is a potential alternative. Our objective was to generate validity evidence for a serious game in assessing multi-patient care skills among a variety of learners. Methods. This was a cross-sectional validation study using a digital serious game VitalSignsTM simulating multi-patient care within a pediatric ED. Subjects completed 5 virtual “shifts,” triaging, stabilizing, and discharging or admitting patients within a fixed time period; patients arrived at cascading intervals with pre-programmed deterioration if neglected. Predictor variables included generic multi-tasking ability, video game experience, medical knowledge, and clinical efficiency with real patients. Outcome metrics in 3 domains measured diagnostic accuracy (i.e. critical orders, diagnoses), efficiency (i.e. number of patients, time-to-order) and critical thinking (number of differential diagnoses); MANOVA determined differences between novice learners and expected expert physicians. Spearman Rank correlation determined associations between levels of expertise. Results. Ninety-five subjects’ gameplays were analyzed. Diagnostic accuracy and efficiency distinguished skill level between residency trained (residents, fellows and attendings) and pre-residency trained (medical students and undergraduate) subjects, particularly for critical orders, patients seen, and correct diagnoses (p < 0.003). There were moderate to strong correlations between the game’s diagnostic accuracy and efficiency metrics compared to level of training, including patients seen (rho = 0.47, p < 0.001); critical orders (rho = 0.80, p < 0.001); time-to-order (rho = −0.24, p = 0.025); and correct diagnoses (rho = 0.69, p < 0.001). Video game experience also correlated with patients seen (rho = 0.24, p = 0.003). Conclusion. A digital serious game depicting a busy virtual ED can distinguish between expected experts in multi-patient care at the pre- vs. post-residency level. Further study can focus on whether the game appropriately assesses skill acquisition during residency.

Current Models for Inpatient and Emergency Room Ophthalmology Consultation in U.S. Residency Programs

2020 ◽  
Vol 12 (02) ◽  
pp. e171-e174
Author(s):  
Donna H. Kim ◽  
Dongseok Choi ◽  
Thomas S. Hwang
Keyword(s):  
Emergency Department ◽  
Medical Education ◽  
Emergency Room ◽  
Program Directors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Direct Supervision ◽  
Residency Programs ◽  
Residency Program Directors ◽  
Competency Assessments

Abstract Objective This article examines models of patient care and supervision for hospital-based ophthalmology consultation in teaching institutions. Design This is a cross-sectional survey. Methods An anonymous survey was distributed to residency program directors at 119 Accreditation Council for Graduated Medical Education accredited U.S. ophthalmology programs in the spring of 2018. Survey questions covered consult volume, rotational schedules of staffing providers, methods of supervision (direct vs. indirect), and utilization of consult-dedicated didactics and resident competency assessments. Results Of the 119 program directors, 48 (41%) completed the survey. Programs most frequently reported receiving 4 to 6 consults per day from the emergency department (27, 55.1%) and 4 to 6 consults per day from inpatient services (26, 53.1%). Forty-seven percent of programs reported that postgraduate year one (PGY-1) or PGY-2 residents on a dedicated consult rotation initially evaluate patients. Supervising faculty backgrounds included neuro-ophthalmology, cornea, comprehensive, or a designated chief of service. Staffing responsibility is typically shared by multiple faculty on a daily or weekly rotation. Direct supervision was provided for fewer of emergency room consults (1–30%) than for inpatient consults (71–99%). The majority of programs reported no dedicated didactics for consultation activities (27, 55.1%) or formal assessment for proficiency (33, 67.4%) prior to the initiation of call-related activities without direct supervision. Billing submission for consults was inconsistent and many consults may go financially uncompensated (18, 36.7%). Conclusion The majority of hospital-based ophthalmic consultation at academic centers is provided by a rotating pool of physicians supervising a lower level resident. Few programs validate increased levels of graduated independence using specific assessments.

scholarly journals Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study

2015 ◽  
Vol 4 (5) ◽  
pp. 47 ◽  
Author(s):  
Jean Claude Byiringiro ◽  
Rex Wong ◽  
Caroline Davis ◽  
Jeffery Williams ◽  
Joseph Becker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Success Factors ◽  
Low Cost ◽  
Post Intervention ◽  
Triage System ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
The Impact

Few case studies exist related to hospital accident and emergency department (A&E) quality improvement efforts in lowerresourced settings. We sought to report the impact of quality improvement principles applied to A&E overcrowding and flow in the largest referral and teaching hospital in Rwanda. A pre- and post-intervention study was conducted. A linked set of strategies included reallocating room space based on patient/visitor demand and flow, redirecting traffic, establishing a patient triage system and installing white boards to facilitate communication. Two months post-implementation, the average number of patients boarding in the A&E hallways significantly decreased from 28 (pre-intervention) to zero (post-intervention), p < .001. Foot traffic per dayshift hour significantly decreased from 221 people to 160 people (28%, p < .001), and non-A&E related foot traffic decreased from 81.4% to 36.3% (45% decrease, p < .001). One hundred percent of the A&E patients have been formally triaged since the implementation of the newly established triage system. Our project used quality improvement principles to reduce the number of patients boarding in the hallways and to decrease unnecessary foot traffic in the A&E department with little investment from the hospital. Key success factors included a collaborative multidisciplinary project team, strong internal champions, data-driven analysis, evidence-based interventions, senior leadership support, and rapid application of initial implementation learnings. Results to date show the application of quality improvement principles can help hospitals in resource-limited settings improve quality of care at relatively low cost.

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