scholarly journals Conceptual Model of Emergency Department Utilization among Deaf and Hard-of-Hearing Patients: A Critical Review

2021 ◽  
Vol 18 (24) ◽  
pp. 12901
Author(s):  
Tyler G. James ◽  
Julia R. Varnes ◽  
Meagan K. Sullivan ◽  
JeeWon Cheong ◽  
Thomas A. Pearson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Services ◽  
Conceptual Model ◽  
Hard Of Hearing ◽  
Emergency Department Utilization ◽  
Services Research ◽  
Factors Influencing ◽  
Care Processes ◽  
Improvement Interventions ◽  
Quality Improvement Interventions

Deaf and hard-of-hearing (DHH) populations are understudied in health services research and underserved in healthcare systems. Existing data indicate that adult DHH patients are more likely to use the emergency department (ED) for less emergent conditions than non-DHH patients. However, the lack of research focused on this population’s ED utilization impedes the development of health promotion and quality improvement interventions to improve patient health and quality outcomes. The purpose of this study was to develop a conceptual model describing patient and non-patient (e.g., community, health system, provider) factors influencing ED utilization and ED care processes among DHH people. We conducted a critical review and used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The resulting Conceptual Model of Emergency Department Utilization Among Deaf and Hard-of-Hearing Patients provides predisposing, enabling, and reinforcing factors influencing DHH patient ED care seeking and ED care processes. The model highlights the abundance of DHH patient and non-DHH patient enabling factors. This model may be used in quality improvement interventions, health services research, or in organizational planning and policymaking to improve health outcomes for DHH patients.

Factors Influencing the Frequency of Emergency Department Utilization by Individuals with Substance Use Disorders

2016 ◽  
Vol 87 (4) ◽  
pp. 713-728 ◽  
Author(s):  
Christophe Huynh ◽  
Francine Ferland ◽  
Nadine Blanchette-Martin ◽  
Jean-Marc Ménard ◽  
Marie-Josée Fleury
Keyword(s):  
Emergency Department ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Emergency Department Utilization ◽  
Factors Influencing

Use of prone position restraint within a mental health trust

2017 ◽  
Vol 22 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Elizabeth Shaw ◽  
Anushtayini Sivananthan ◽  
David Phillip Wood ◽  
James Partington ◽  
Alison Pearl Reavy ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Prone Position ◽  
Clinical Audit ◽  
Physical Restraint ◽  
Challenging Behaviour ◽  
Improvement Project ◽  
Content Type ◽  
Care Processes ◽  
Improvement Interventions ◽  
Quality Improvement Interventions

Purpose The purpose of this paper is to improve the quality of care of patients presenting with challenging behaviour. Design/methodology/approach Current guidelines are described, and adherence to the standards is audited, with a particular emphasis on physical restraint. Findings The results of the clinical audit revealed that in the substantial majority of episodes of challenging behaviour, non-physical techniques were used prior to the need to intervene with physical restraint; however, when physical restraint was used, there was limited use of staff debriefs to facilitate reflection- and work-based learning. A potential diagnostic link to the likelihood of use of prone position restraint was also a finding. The results of a quality improvement project undertaken in response to the findings of the clinical audit demonstrated significant and sustained improvements in adherence to most standards. Practical implications Continuous improvements to the safety of both patients and staff when managing acute challenging behaviour requires ongoing quality improvement interventions underpinned by the application of human factors principles. Originality/value The completion of this audit cycle suggests that it is useful to measure specific points of care processes, however, continuous improvement interventions are indicated to lead to sustained improvement – in this paper this is demonstrated by the safer management of challenging behaviour.

scholarly journals A Literature Review on Care at the End-of-Life in the Emergency Department

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Roberto Forero ◽  
Geoff McDonnell ◽  
Blanca Gallego ◽  
Sally McCarthy ◽  
Mohammed Mohsin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Services ◽  
End Of Life ◽  
Policy Development ◽  
Social Issues ◽  
Models Of Care ◽  
Future Research ◽  
Services Research ◽  
Life Issues ◽  
Acute Hospitals

The hospitalisation and management of patients at the end-of-life by emergency medical services is presenting a challenge to our society as the majority of people approaching death explicitly state that they want to die at home and the transition from acute care to palliation is difficult. In addition, the escalating costs of providing care at the end-of-life in acute hospitals are unsustainable. Hospitals in general and emergency departments in particular cannot always provide the best care for patients approaching end-of-life. The main objectives of this paper are to review the existing literature in order to assess the evidence for managing patients dying in the emergency department, and to identify areas of improvement such as supporting different models of care and evaluating those models with health services research. The paper identified six main areas where there is lack of research and/or suboptimal policy implementation. These include uncertainty of treatment in the emergency department; quality of life issues, costs, ethical and social issues, interaction between ED and other health services, and strategies for out of hospital care. The paper concludes with some areas for policy development and future research.

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