scholarly journals Assessment of consultation impact on emergency department operations through novel metrics of responsiveness and decision-making efficiency

CJEM ◽  
2014 ◽  
Vol 16 (03) ◽  
pp. 185-192 ◽  
Author(s):  
Patricia A. Lee ◽  
Brian H. Rowe ◽  
Grant Innes ◽  
Eric Grafstein ◽  
Renee Vilneff ◽  
...  
Keyword(s):  
Decision Making ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Consultation Process ◽  
Cross Sectional ◽  
Impact Index ◽  
Time Stamps ◽  
Consultation Request ◽  
Consultation Time

ABSTRACT Objectives: Requests for specialty consultation are common in emergency departments (EDs) and often contribute to delays in throughput. Our objectives were to describe the contribution of the consultation process to total ED length of stay (LOS) through novel metrics and illustrate causes of delay. Methods: We conducted a prospective cross-sectional study at three Canadian tertiary care centres. Adult ED patients with requested medical/surgical consultations were enrolled. We created original metric intervals: total consultation time (TCT) defined as the interval from the initial consultation request to the disposition decision, consult response time (CRT) from the request to the consultant arrival, and decision-making interval (DMI) from arrival to the disposition decision. The consultation impact index (CII) was defined as the percentage of ED LOS consumed by the TCT. Reasons for delay were documented if time stamps exceeded preset benchmarks. Results: The median TCT for 285 patients was 138 minutes (interquartile range [IQR]: 82–239 minutes), whereas the median total ED LOS was 778 minutes (IQR 485–1,274 minutes). The median CRT was 55 minutes (IQR 21–115 minutes), and the median DMI was 58 minutes (IQR 25–126 minutes). The CII measured 26% (95% CI 23–28). Major contributors to consultation delay included urgent ward issues, simultaneous ED consultations, and the need for additional laboratory or radiographic investigations. Conclusion: The consultation process is highly variable and has an important impact on ED LOS. We describe novel measures related to consultation performance and provide an analysis of what causes delays. These results can be used to seek improvements in the consulting process.

Confidence toward vaccination as reported by parents of children admitted to a tertiary care hospital in Riyadh, Saudi Arabia: A cross sectional study

Vacunas ◽  
2020 ◽  
Vol 21 (2) ◽  
pp. 95-104 ◽  
Author(s):  
Y.M. AlGoraini ◽  
N.N. AlDujayn ◽  
M.A. AlRasheed ◽  
Y.E. Bashawri ◽  
S.S. Alsubaie ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

A Cross-sectional Study of Undiagnosed Fever in a Rural Population at a Tertiary Care Hospital of West Bengal

2018 ◽  
Vol 4 (3) ◽  
Author(s):  
Nandini Chatterjee ◽  
Supratick Chakraborty ◽  
Mainak Mukhopadhyay ◽  
Sinjon Ghosh ◽  
Bikramjit Barkandaj ◽  
...  
Keyword(s):  
Rural Population ◽  
West Bengal ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Prelicensure Nursing Students’ COVID-19 Attitude Impact on Nursing Career Decision during Pandemic Threat in Taiwan: A Cross-Sectional Study

2021 ◽  
Vol 18 (6) ◽  
pp. 3272
Author(s):  
Shu-Chun Lin ◽  
Lee-Fen Ni ◽  
Yu-Ming Wang ◽  
Shu Hsin Lee ◽  
Hung-Chang Liao ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Students ◽  
Perceived Control ◽  
Career Decision ◽  
Cross Sectional Study ◽  
Attitude Scale ◽  
Sectional Study ◽  
Career Decision Making ◽  
Cross Sectional ◽  
Prelicensure Nursing

The COVID-19 pandemic may cause a nursing shortage. Prelicensure nursing students who are exposed to high-stress COVID-19 events are related to defective career decision-making. This study validated the COVID-19 attitude scale and clarified how their attitudes about COVID-19 affected their behavioral intentions toward career decision-making. We conducted a cross-sectional study and recruited a convenience sample of 362 prelicensure nursing students from Northern and Central Taiwan. Two measurements were applied, including the Nursing Students Career Decision-making instrument and COVID-19 attitude scale. We used AMOS (version 22.0) to perform a confirmatory factor analysis. The Cronbach α of the COVID-19 attitude scale was 0.74 and consisted of four factors. The most positive attitude was the nursing belief factor, and the least positive factor was emotional burden. Prelicensure nursing students’ COVID-19 attitudes were significantly positively associated with their career decision-making attitudes and perceived control (ß = 0.41 and ß = 0.40, respectively; p < 0.001). All the key latent variables explained significantly 23% of the variance in the career decision-making behavioral intentions module. In conclusion, the COVID-19 attitude scale is valid. Although the prelicensure nursing students’ COVID-19 attitudes had no direct effect on career decision-making intentions, they had a direct effect on career decision-making attitudes and the perceived control.

scholarly journals The pattern of thyroiditis in multiple sclerosis: a cross-sectional study in a tertiary care hospital in Egypt

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Nearmeen M. Rashad ◽  
Marwa G. Amer ◽  
Waleed M. Reda Ashour ◽  
Hassan M. Hassanin
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Demyelinating Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cmv Infection ◽  
Cross Sectional ◽  
Disease Modifying Drugs

Abstract Background Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system with varied clinical features. Disease-modifying drugs (DMDs) of MS associated with different types of thyroiditis. In this cross-sectional study, we aimed to assess the prevalence of thyroid dysfunction in MS and to investigate the association between DMDs and the risk of thyroiditis in MS. A cross-sectional study included 100 patients with relapsing-remitting multiple sclerosis (RRMS) in relapse, and the diagnosed was according to revised McDonald’s criteria 2010. Results Our results revealed that the prevalence of thyroiditis was 40%; autoimmune (34%) and infective (6%) among patients with RRMS in relapse and cerebellar symptoms were significantly higher in patients with thyroiditis compared to patients without thyroiditis. Regarding the association between DMDs and thyroiditis, the prevalence of patients treated with interferon-beta-1b was higher in MS patients with thyroiditis compared to MS patients without thyroiditis. However, the prevalence of patients treated with interferon-beta-1a was lower in MS patients with thyroiditis compared to MS patients without thyroiditis. In addition, we found CMV infection was more common in patients treated by interferon beta-1b and candida infection was common in patients treated by fingolimod. Conclusions Thyroiditis is commonly observed in patients with RRMS in relapse and higher prevalence of patients treated with interferon-beta-1b which is commonly associated with thyroiditis and CMV infection; however, candida thyroid infection was common in MS patients treated by fingolimod.

scholarly journals Factors influencing decision-making to accept elective caesarean section: A descriptive cross-sectional study

Heliyon ◽  
2021 ◽  
pp. e07755
Author(s):  
Victoria Bam ◽  
Alberta Yemotsoo Lomotey ◽  
Abigail Kusi-Amponsah Diji ◽  
Hayford Isaac Budu ◽  
Dorothy Bamfo-Ennin ◽  
...  
Keyword(s):  
Decision Making ◽  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Influencing
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