Pediatric Asthma Care in the Emergency Department: Measuring the Quality of History-Taking and Discharge Planning

1999 ◽  
Vol 36 (1) ◽  
pp. 129-138 ◽  
Author(s):  
Ellen F. Crain ◽  
Kathleen M. Mortimer ◽  
Laurie J. Bauman ◽  
Carolyn M. Kercsmar ◽  
Kevin B. Weiss ◽  
...  
Keyword(s):  
Emergency Department ◽  
Discharge Planning ◽  
Pediatric Asthma ◽  
History Taking ◽  
Asthma Care

scholarly journals Utilization and effects of mobile electronic clinical decision support on pediatric asthma care quality in the emergency department and inpatient setting

JAMIA Open ◽  
2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Ellen Kerns ◽  
Russell McCulloh ◽  
Sarah Fouquet ◽  
Corrie McDaniel ◽  
Lynda Ken ◽  
...  
Keyword(s):  
Emergency Department ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Pediatric Asthma ◽  
Clinical Decision ◽  
Care Quality ◽  
Asthma Care ◽  
Mixed Effect ◽  
National Quality ◽  
Electronic Clinical Decision Support

Abstract Objective To determine utilization and impacts of a mobile electronic clinical decision support (mECDS) on pediatric asthma care quality in emergency department and inpatient settings. Methods We conducted an observational study of a mECDS tool that was deployed as part of a multi-dimensional, national quality improvement (QI) project focused on pediatric asthma. We quantified mECDS utilization using cumulative screen views over the study period in the city in which each participating site was located. We determined associations between mECDS utilization and pediatric asthma quality metrics using mixed-effect logistic regression models (adjusted for time, site characteristics, site-level QI project engagement, and patient characteristics). Results The tool was offered to clinicians at 75 sites and used on 286 devices; cumulative screen views were 4191. Children’s hospitals and sites with greater QI project engagement had higher cumulative mECDS utilization. Cumulative mECDS utilization was associated with significantly reduced odds of hospital admission (OR: 0.95, 95% CI: 0.92–0.98) and higher odds of caregiver referral to smoking cessation resources (OR: 1.08, 95% CI: 1.01–1.16). Discussion We linked mECDS utilization to clinical outcomes using a national sample and controlling for important confounders (secular trends, patient case mix, and concomitant QI efforts). We found mECDS utilization was associated with improvements in multiple measures of pediatric asthma care quality. Conclusion mECDS has the potential to overcome barriers to dissemination and improve care on a broad scale. Important areas of future work include improving mECDS uptake/utilization, linking clinicians’ mECDS usage to clinical practice, and studying mECDS’s impacts on other common pediatric conditions.

Improving Pediatric Asthma Care Through Surveillance: The Illinois Emergency Department Asthma Collaborative

PEDIATRICS ◽  
2006 ◽  
Vol 117 (Supplement 2) ◽  
pp. S96-S105 ◽  
Author(s):  
Richard O. Lenhardt ◽  
Catherine D. Catrambone ◽  
Michael F. McDermott ◽  
James Walter ◽  
Seymour G. Williams ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pediatric Asthma ◽  
Asthma Care

Pathways to Improve Pediatric Asthma Care: A Multisite, National Study of Emergency Department Asthma Pathway Implementation

2020 ◽  
Vol 223 ◽  
pp. 100-107.e2 ◽  
Author(s):  
Sunitha V. Kaiser ◽  
Michael D. Johnson ◽  
Theresa A. Walls ◽  
Stephen J. Teach ◽  
Esther M. Sampayo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pediatric Asthma ◽  
National Study ◽  
Asthma Care

scholarly journals 168 Improving Pediatric Asthma Care via Outreach to a Community Emergency Department

2014 ◽  
Vol 64 (4) ◽  
pp. S60-S61
Author(s):  
T. Walls ◽  
N. Hughes ◽  
C. Rawlinson ◽  
J. Chamberlain ◽  
K. Brown
Keyword(s):  
Emergency Department ◽  
Pediatric Asthma ◽  
Asthma Care

scholarly journals Improving patient waiting times and quality of care by arranging access to notes from a neighbouring trust

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S175-S176
Author(s):  
Georgios Basdanis ◽  
Cormac Fenton
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Quality Of Care ◽  
Median Time ◽  
Discharge Planning ◽  
Waiting Times ◽  
Clinical Information ◽  
North West ◽  
Time Required

AimsWe aim to improve waiting times in the Emergency Department and improve the overall quality of care of out-of-area patients by arranging for the liaison team to have access to the electronic notes system of a neighbouring trust.MethodSt Thomas’ Hospital is located in south London, right opposite the City of Westminster. As a result, approximately 20% of patients we see in mental health liaison are from that locality. Given that they belong to a different trust, we do not have access to their notes, which leads to a delay in trying to establish whether they are known to local mental health services. Often, staff are reluctant to divulge information. When information is shared, it is often late and/or incomplete. We approached the Chief Clinical Information Officer and Head of Information Governance from Central and North West London (CNWL) NHS Foundation Trust. We held weekly meetings which included both IT departments. Our IT had to install the electronic notes application (SystmOne) on our computers and open relevant firewall ports. The information is access through an NHS Smartcard, therefore CNWL had to authorise read-only Smartcard profiles for every member of the liaison team. A quick reference guide was created for all staff that would be using the new application. The system went live on 21 January 2021.ResultWe audited patient outcomes in December 2020 and February 2021 for initial comparison. In December 2020, the median time from referral to discharge was 6 hours 35 minutes. 25% of patients were admitted and 17% discharged with HTT. In February 2021, the median time from referral to discharge was 3 hours 19 minutes. 16% of patients were admitted and 5% discharged with HTT.ConclusionIt is likely that by reducing the time required for collateral information, overall waiting times in the emergency department will be reduced. Clinicians are likely to feel more confident in their discharge planning if they have access to all clinical notes and previous risk assessments, which might in turn reduce referrals to HTT or admission. There should be further attempts by neighbouring NHS trusts, especially in London, to ensure access to their electronic notes system in order to reduce waiting times and improve the quality of patient care. We have already been approached for more information by a trust in North London who are interested in establishing access to a neighbouring trust's notes.

Usability of a Web-based Software Tool for History Taking in the Emergency Department

2020 ◽  
Vol 19 (3) ◽  
pp. 131-137
Author(s):  
Johanna Frey Renggli ◽  
◽  
Ceylan Eken ◽  
Victoria Siegrist ◽  
Ricardo Nieves Ortega ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical History ◽  
Software Tool ◽  
Medical History Taking ◽  
Medical Attention ◽  
Diagnostic Process ◽  
History Taking ◽  
Web Based ◽  
Medical Histories

Medical history taking is an important step within the diagnostic process. This study aims to assess the quality and usability (effectiveness, satisfaction, efficiency) of a web-based medical history taking app in the emergency department. During three weeks, patients and junior physicians filled out study questionnaires about the app. Senior physicians rated the quality of medical histories taken by junior physicians and app. In 241 patients, the studied app showed excellent usability with patients not in need of immediate medical attention. Senior physicians rated medical histories as more complete when app was used by patients in comparison to conventional history taking alone (p<0.01). Current app could not substitute medical history taking by physicians, but could definitely rather be used to gather ancillary information.

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