scholarly journals An Acute Medical Unit in a Korean Tertiary Care Hospital Reduces the Length of Stay and Waiting Time in the Emergency Department

2017 ◽  
Vol 32 (12) ◽  
pp. 1917 ◽  
Author(s):  
Jung Hun Ohn ◽  
Nak-Hyun Kim ◽  
Eun Sun Kim ◽  
Seon Ha Baek ◽  
Yejee Lim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Waiting Time ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Unit ◽  
Acute Medical Unit

scholarly journals Emergency Stay Duration of Patients in Emergency Department of A Tertiary Care Hospital in Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (222) ◽  
Author(s):  
Prashant Simkhada ◽  
Shradha Acharya ◽  
Roshan Lama ◽  
Sujata Dahal ◽  
Nita Lohola ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Duration Of Stay ◽  
The Mean

Introduction: Emergency department of a hospital is responsible for providing medical and surgical care to patients arriving at the hospital in need of immediate care. Emergency department is not staffed or equipped to provide prolonged care. Duration of stay in the Emergency department directly affects the quality of patient care. Longer length of stay is associated with Emergency department overcrowding, decline in patient care, increased mortality and decreased patients satisfaction. The main aim of this study is to find the mean stay duration of patients in the emergency department of a tertiary care hospital in Nepal.Methods: This is a descriptive cross-sectional study which was conducted in a tertiary care teaching hospital from Jan 15,2019 to Jan 30, 2019. Ethical clearance was obtained from Kathmandu Medical College- Instutional Review Committee. The calculated sample size was 587. Consecutive sampling technique was used. The data thus obtained was entered in SPSS version 20 and necessary calculations were done. Results: The mean emergency stay duration was obtained to be 3.18 hours at 95% confidence interval (C.I  and standard deviation was 2.51 hours. Female had longer mean duration of stay (3.25 hours) compared to male (3.11 hours). The maximum length of stay was 15.3 hours. Most of the patients attending the emergency department were discharged right through the emergency department 398 ( 67.8%). Mean duration of stay was longest (5.06 hours) for the referral group. Conclusions: The mean stay duration in Emergency Department of tertiary care hospital in Nepal is getting shorter compared to similar study done previously.

scholarly journals Length of Stay in the Emergency Department during COVID-19 Pandemic in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Suraj Singh ◽  
Bibek Koirala ◽  
Rabin Thami ◽  
Anupama Thapa ◽  
Bijay Thapa ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Children's Hospital ◽  
Children’S Hospital

Introduction: Emergency Department overcrowding has become worsening problem internationally which may affect patient, emergency department efficiency and quality of care and this may lead to increased risk of in hospital mortality, higher costs, medical errors and longer times to treatment. With this pandemic COVID-19 likely to go on for months, if not a year or longer, the Emergency Department should be prepared for large influx of patients infected with COVID-19. The aim of this study is to find-out the length of stay in emergency department during COVID-19 pandemic at a tertiary care hospital in Nepal. Methods: This is a descriptive cross-sectional study conducted in the Emergency Department of Kanti Children’s Hospital. Ethical clearance was obtained from Institutional review committee Kanti Children’s Hospital. Data collection was done from the emergency records from July 23, 2020 to July 29, 2020. The calculated sample size was 211. The data thus obtained was entered in Statistical Package for the Social Science software version 20 and necessary calculations were done. Results: The median length of stay in emergency department was found to be 1.75 hours (Interquartile range 0 to 30 hours). Conclusions: Definitive management starts in respective wards and Intensive Care Units. During COVID-19, with longer emergency stay, chances of cross-infection increases, and the health workers serving in emergency department will be at risks. So guidelines for shorter emergency stay should be implemented.

VALIDATION OF QUICK COVID SEVERITY INDEX IN COVID PATIENTS ADMITTED THROUGH EMERGENCY DEPARTMENT OF A PRIVATE TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA

2021 ◽  
pp. 53-55
Author(s):  
Harsimran Singh Das
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Tertiary Care Hospital ◽  
Clinical Status ◽  
Tertiary Care ◽  
Severity Index ◽  
Adult Patients ◽  
Care Hospital ◽  
Oxygen Requirement ◽  
Clinical Tool

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.

THE IMPACT OF ANTIMICROBIAL STEWARDSHIP ON THE PATTERNS OF ANTIBIOTICS’ PRESCRIPTION AND CLINICAL OUTCOMES IN THE MEDICAL WARD OF A MALAYSIAN TERTIARY CARE HOSPITAL

2021 ◽  
pp. 20-25
Author(s):  
OVAIS ULLAH SHIRAZI ◽  
NORNY SYAFINAZ AB RAHMAN ◽  
CHE SURAYA ZIN ◽  
HANNAH MD MAHIR ◽  
SYAMHANIN ADNAN
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Antimicrobial Stewardship ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Ward ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Slope Change ◽  
The Impact

Objective: To evaluate the impact of antimicrobial stewardship (AMS) on antibiotic prescribing patterns and certain clinical outcomes, the length of stay (LOS) and the re-admission rate (RR) of the patients treated within the medical ward of a tertiary care hospital in Malaysia. Methods: This quasi-experimental study was conducted retrospectively. The prescriptions of the AMS included alert antibiotics (AA) such as cefepime, ceftazidime, colistin (polymyxin E), imipenem-cilastatin, meropenem, piperacillin-tazobactam and vancomycin were reviewed for the period of 24 mo before (May, 2012–April, 2014) and after (May, 2014–April, 2016) the AMS implementation for the patients who were treated within the medical ward of a Malaysian tertiary care hospital. Patterns of antibiotics prescribed were determined descriptively. The impact of the AMS on the length of stay (LOS) and readmission rate (RR) was determined by the interrupted time series (ITS) comparative analysis of the pre-and post-AMS segments segregated by the point of onset (May, 2014) of the AMS program. Data analysis was performed through autoregressive integrated moving average (ARIMA) Winter Additive model and the Games-Howell non-parametric post hoc test by using IBM Statistical Package for Social Sciences version 25.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: A total of 1716 prescriptions of the AA included for the AMS program showed that cefepime (623, 36.3%) and piperacillin-tazobactam (424, 24.7%) were the most prescribed antibiotics from May 2012 to April 2016. A 23.6% drop in the number of the AA prescriptions was observed during the 24-month post-AMS period. The LOS of the patients using any of the AA showed a post-AMS decline by 3.5 d. The patients’ LOS showed an average reduction of 0.12 (95% CI, 0.05–0.19, P=0.001) with the level and slope change of 0.18 (95% CI, 0.04–0.32, P=0.02) and 0.074 (95% CI, 0.02–0.12, P=0.002), respectively. Similarly, the percent RR reduced from 20.0 to 9.85 during the 24-month post-AMS period. The observed post-AMS mean monthly reduction of the RR for the patients using any AA was 0.38 (95% CI, 0.23–0.53, P<0.001) with the level and slope change of 0.33 (95% CI, 0.14–0.51, P=0.02) and 0.37 (95% CI, 0.16–0.58, P=0.001), respectively. Conclusion: The AMS program of a Malaysian tertiary care hospital was a coordinated set of interventions implemented by the AMS team of the hospital that comprised of the infectious diseases (ID) physician, clinical pharmacists and microbiologist. The successful implementation of the AMS program from May, 2014 to April, 2016 within the medical ward resulted in the drop of the number of AA prescriptions that sequentially resulted in the significant (P<0.05) post-AMS reduction of the LOS and the RR.

Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan

2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Syed Ghazanfar Saleem ◽  
Saima Ali ◽  
Nida Ghouri ◽  
Quratulain Maroof ◽  
Muhammad Imran Jamal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Patient Perception ◽  
Care Hospital ◽  
Structured Interviews ◽  
Privacy Concerns ◽  
Creative Commons ◽  
Privacy And Confidentiality ◽  
And Behavior

Background and Objective: Maintaining privacy and ensuring confidentiality with patients is paramount to developing an effective patient-provider relationship. This is often challenging in over-crowded Emergency Departments (EDs). This survey was designed to explore patients’ perceptions on maintenance of privacy and confidentiality and their subsequent interactions with providers in a busy tertiary care hospital in Karachi. Methods: Trained nursing staff conducted structured interviews with 571 patients who presented to The Indus Hospital (TIH) ED from January to December 2020. All patients were 14 years of age or older, could speak and understand Urdu, and provide informed consent. Patients were asked about their perceptions of privacy and confidentiality in the ED and whether this affected their interactions with providers. Results: Respondents were primarily men (64%) under the age of 45 (62%) presenting for the first time (49%). The majority of patients felt that privacy and confidentiality were maintained, however 10% of patients reported that they had rejected examination due to privacy concerns and 15% of patients reported that they had changed or omitted information provided to a provider due to confidentiality concerns. There was correlation between privacy and confidentiality concerns and patient-provider interactions (p<0.0001). Conclusions: Despite the often over-crowded and busy environment of the ED, patients generally felt that privacy and confidentiality were maintained. Given the correlation between perception and behavior and the importance of an effective patient-provider relationship, particularly in the acute setting when morbidity and mortality is high, initiatives that focus on maintaining privacy and confidentiality should be pursued. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 How to cite this:Saleem SG, Ali S, Ghouri N, Maroof Q, Jamal MI, Aziz T, et al. Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2022;38(2):351-355.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Triaging the triage: reducing waiting time to triage in the emergency department at a tertiary care hospital in New Delhi, India

2019 ◽  
Vol 36 (9) ◽  
pp. 558-563
Author(s):  
Akshay Kumar ◽  
Dheeneshbabu Lakshminarayanan ◽  
Nitesh Joshi ◽  
Sonali Vaid ◽  
Sanjeev Bhoi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Waiting Time ◽  
Tertiary Care ◽  
Time Of Arrival ◽  
New Delhi ◽  
Care Hospital ◽  
Senior Leadership ◽  
Frontline Staff ◽  
Patient Load ◽  
Hot Weather

BackgroundProlonged wait times prior to triage outside the emergency department (ED) were a major problem at our institution, compromising patient safety. Patients often waited for hours outside the ED in hot weather leading to exhaustion and clinical deterioration. The aim was to decrease the median waiting time to triage from 50 min outside ED for patients to <30 min over a 4-month period.MethodsA quality improvement (QI) team was formed. Data on waiting time to triage were collected between 12 pm and 1 pm. Data were collected by hospital attendants and recorded manually. T1 was noted as a time of arrival outside the ED, and T2 was noted as the time of first medical contact. The QI team used plan–do–study–act cycles to test solutions. Change ideas to address these gaps were tested during May and June 2018. Change ideas were focused on improving the knowledge and skills of staff posted in triage and reducing turnover of triage staff. Data were analysed using run chart rules.ResultsWithin 6 weeks, the waiting time to triage reduced to <30 min (median, 12 min; IQR, 11 min) and this improvement was sustained for the next 8 weeks despite an increase in patient load.ConclusionThe authors demonstrated that people new to QI could use improvement methods to address a specific problem. It was the commitment of the frontline staff, with the active support of senior leadership in the department that helped this effort succeed.

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