scholarly journals Facing the Emergency Department crisis in Italy

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Daniele Coen ◽  
Ivo Casagranda ◽  
Mario Cavazza ◽  
Gianfranco Cervellin ◽  
Lorenzo Ghiadoni ◽  
...  
Keyword(s):  
Emergency Department ◽  
General Practice ◽  
Health Systems ◽  
Medical Doctor ◽  
Practice Physician ◽  
Western Countries

Since a few years ago health systems in the western countries have a new problem to face: being a Medical Doctor (MD), especially a hospital or a general practice physician, is less and less appealing for the young generations. [...]

Ethico-legal issues by medical specialism A–M

2021 ◽  
pp. 229-260
Author(s):  
Anna Smajdor ◽  
Jonathan Herring ◽  
Robert Wheeler
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
General Practice ◽  
Interventional Radiology ◽  
Cardiac Surgery ◽  
Elderly Care ◽  
Legal Issues ◽  
Relative Risks ◽  
Clinical Records ◽  
Self Defence

This chapter covers Ethico-legal issues by medical specialism and includes topics on the following subjects (A-M): Anaesthetics: Child refusing treatment, Cardiac Surgery: Candour, Dentistry: Gillick Competence, Dermatology; a right to treatment?, Diabetology: Maintaining clinical records, Elderly Care: Refusal of Treatment, Emergency Department: Knife Crime, Emergency Department: Restraint/Self-Defence, Endocrinology: Wishes/Feelings, ENT: Consent/Necessity, Family Planning: Gillick Competence, Gastroenterology: Mental Health Act, General Practice: Cultural Circumcision, General Surgery: Need for clinicians to keep up to date, Genetics: Confidentiality, Gynaecology: abortion, HIV: Confidentiality, Intensive Care: DNACPR, Interventional Radiology: Relative Risks, and Maxillofacial: Candour.

The mouth, lips, and teeth

2018 ◽  
pp. 389-437
Author(s):  
Mike Perry
Keyword(s):  
Emergency Department ◽  
General Practice ◽  
Anatomical Region ◽  
Starting Point ◽  
Common Problems ◽  
Clinical Problems

This chapter looks at diseases and conditions of the mouth, lips, and teeth that may present acutely to an emergency department, general practice, or ward. It aims to equip the reader with the necessary knowledge to enable them to quickly and accurately triage and diagnose common clinical problems. Referral pathways and management are also discussed. Generally speaking, patients do not present with a ready-made diagnosis, but rather with either a symptom located to an anatomical region (e.g. toothache, lump, or headache), or an obvious problem (e.g. nose bleed or injury). This is the starting point (‘Common presentations’ and ‘Common problems and their causes’). The next section (‘Useful questions and what to look for’) lists key diagnostic elements in relation to each symptom. The remainder of each chapter details how to examine each site, useful investigations (emergency department and outpatients), and some notes on the conditions themselves. This is a useful aid for the non-specialist and those preparing for clinical examinations.

The front of the neck

2018 ◽  
pp. 123-176
Author(s):  
Mike Perry
Keyword(s):  
Emergency Department ◽  
General Practice ◽  
Anatomical Region ◽  
Starting Point ◽  
Common Problems ◽  
Clinical Problems

This chapter looks at diseases and conditions of the front of the neck that may present acutely to an emergency department, general practice, or ward. It aims to equip the reader with the necessary knowledge to enable them to quickly and accurately triage and diagnose common clinical problems. Referral pathways and management are also discussed. Generally speaking, patients do not present with a ready-made diagnosis, but rather with either a symptom located to an anatomical region (e.g. toothache, lump, or headache), or an obvious problem (e.g. nose bleed or injury). This is the starting point (‘Common presentations’ and ‘Common problems and their causes’). The next section (‘Useful questions and what to look for’) lists key diagnostic elements in relation to each symptom. The remainder of each chapter details how to examine each site, useful investigations (emergency department and outpatients), and some notes on the conditions themselves. This is a useful aid for the non-specialist and those preparing for clinical examinations.

scholarly journals 4375 Developing team science for practical applications of artificial intelligence in health systems to improve value and outcomes: A case study in reducing avoidable emergency department use

2020 ◽  
Vol 4 (s1) ◽  
pp. 117-117
Author(s):  
Vladimir G. Manuel ◽  
Eran Halperin ◽  
Jeffrey Chiang ◽  
Kodi Taraszka ◽  
Laura Kim ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Emergency Department ◽  
Health Systems ◽  
Prediction Models ◽  
Interdisciplinary Team ◽  
Learning System ◽  
Emergency Department Use ◽  
System Perspective ◽  
System Leaders ◽  
Computer Scientists

OBJECTIVES/GOALS: Health care systems are complex, dynamic, and varied. Advances in artificial intelligence (AI) are enabling healthcare systems to use their own data to elicit patterns and design suitable interventions. To realize this potential, computer scientists and clinicians need an effective, practical, and replicable approach to collaboration METHODS/STUDY POPULATION: In this study, computer scientists partnered with clinicians to investigate predictors of avoidable emergency department use. The team sought an approach to computational medicine that could increase the relevance and impact of prediction to solve pressing problems in the health system. The team adopted an emergent architecture that engaged system leaders, computer scientists, data scientists, health services researchers, and practicing clinicians with deep ambulatory and inpatient knowledge to form the initial questions that shaped the prediction model; to understand nuances of coding and recording in source data and the implications for models; and to generate insights for promising points of intervention. The team recorded decisions and challenges as it progressed to analyze its function. RESULTS/ANTICIPATED RESULTS: Most avoidance models focus on a narrow time period around target events, or on high cost patients and events. This interdisciplinary team used their insights into the health system’s workflows and patient population to adopt a longitudinal approach to their prediction models. They used AI to build models of behavior in the system and consider prevention points across clinical units, time, and place. The holistic, systemwide focus enabled the team to generate insights that the system leaders and subsequently specific clinical units could apply to improve value and outcomes. A facilitated team process using learning system and cooperative network principles allowed a large and modular interdisciplinary team to build a transparent AI modeling process that yielded actionable insights into hypercomplex workflows. DISCUSSION/SIGNIFICANCE OF IMPACT: An architecture for involving diverse stakeholders in computational medicine projects can increase the relevance and impact of AI for solving care delivery problems in complex health systems. Translational science and computational medicine programs can foster this type of engagement and encourage a whole system perspective.

scholarly journals Changing Emergency Department and hospital organization in response to a changing epidemic

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Daniele Coen ◽  
Ciro Paolillo ◽  
Mario Cavazza ◽  
Gianfranco Cervellin ◽  
Andrea Bellone ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Systems ◽  
National Health ◽  
Hospital Organization ◽  
The World

The world is facing a new pandemic that sets the national health systems, their structures and professionals in a crisis never experienced before. (...)

Head, Neck and Dental Emergencies

2018 ◽  
Keyword(s):  
Emergency Department ◽  
General Practice ◽  
Head And Neck ◽  
Clinical Problem ◽  
Anatomical Region ◽  
Starting Point ◽  
Threatening Condition ◽  
Common Problems ◽  
Head Neck ◽  
Targeted Approach

This book is for the non-specialist who may see problems in the head and neck. The aim is to help the reader develop a targeted approach in assessment and management. Such patients may be seen in the emergency department, in general practice, or on the ward. Because true ‘emergencies’ in the head and neck (i.e. a life- or sight-threatening condition) are few in number, a more broadly defined remit has been used, to cover urgent and potentially worrying problems which may present acutely. Generally speaking, patients do not present with a ready-made diagnosis, but rather with either a symptom located to an anatomical region (e.g. toothache, lump, or headache), or an obvious problem (e.g. nose bleed or injury). This is the starting point in each of the anatomically based chapters (‘Common presentations’ and ‘Common problems and their causes’). For each symptom there are a number of possible causes and these are listed. The next section in each chapter (‘Useful questions and what to look for’) lists the important diagnostic elements in relation to each symptom. The aim is to equip the reader with the necessary knowledge to enable them to quickly and accurately triage and diagnose a symptom or clinical problem. The remainder of each chapter details how to examine each site, useful investigations, and some notes on the conditions. Management and referral is also covered. This book is particularly helpful for those unfamiliar with ‘acute conditions’ of the head and neck and for those preparing for clinical examinations.

scholarly journals Osteoporosis among Fallers without Concomitant Fracture Identified in an Emergency Department: Frequencies and Risk Factors

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Bente Glintborg ◽  
Ulrik Hesse ◽  
Thomas Houe ◽  
Jensen Claus Munk ◽  
Jan Pødenphant ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
General Practice ◽  
Body Height ◽  
Mineral Density ◽  
Factors Associated ◽  
Previous Fracture ◽  
Reduced Body ◽  
Normal Bone Mineral Density ◽  
Prior Fracture

We aimed to determine whether the Emergency Department (ED) is a suitable entrance point for osteoporosis screening among fallers without concomitant fracture compared to referral from general practice. Furthermore, to identify factors associated with osteoporosis among fallers.Methods. Patients aged 50–80 years sustaining a low-energy fall without fracture were identified from an ED (n=199). Patients answered a questionnaire on risk factors and underwent osteodensitometry. Data was compared to a group of patients routinely referred to osteodensitometry from general practice (n=201).Results. Among the 199 included fallers, 41 (21%) had osteoporosis. Among these, 35 (85%) reported either previous fracture or reduced body height (>3 cm). These two risk factors were more frequent among fallers with osteoporosis compared to fallers with normal bone mineral density or osteopenia (previous fractureP=.044, height reductionP=.0016). The osteoporosis frequency among fallers from ED did not differ from a similarly aged patient-group referred from general practice (P=.34).Conclusion. Osteodensitometry should be considered among fallers without fracture presenting in the ED, especially if the patient has a prior fracture or declined body height. Since fallers generally have higher fracture risk, the ED might serve as an additional entrance to osteodensitometry compared to referral from primary care.

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