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By Patricio Giacaman Associate Professor
Amy C Plint, Antonia S Stang, Lisa A Calder
BACKGROUND: Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting...
2015: International Journal of Emergency Medicine
Arjun K Venkatesh, Ying Dai, Joseph S Ross, Jeremiah D Schuur, Roberta Capp, Harlan M Krumholz
BACKGROUND: Variation in hospitalization rates have been described for decades, yet little is known about variation in emergency department (ED) admission rates across clinical conditions. We sought to describe variation in ED risk-standardized admission rates (RSAR) and the consistency between condition-specific ED admission rates within hospitals. METHODS: Cross-sectional analysis of the 2009 National Emergency Department Sample, an all-payer administrative, claims dataset...
March 2015: Medical Care
Ellen J Weber
In this issue of Academic Medicine, Webster and colleagues explore the impact of a government-imposed mandate in Ontario, Canada, to limit the length of time patients can stay in the emergency department. The rule is aimed at emergency department crowding, which has been shown to result in poorer-quality care, longer hospital stays, and higher mortality. Webster and colleagues found that learners were concerned about the effect of a time target on both their education and on patient-centered care, and sensed a "hidden curriculum" refocusing teaching on "efficiency rather than safe, compassionate care...
January 2015: Academic Medicine: Journal of the Association of American Medical Colleges
Niels K Rathlev, Christine Bryson, Patty Samra, Lynn Garreffi, Haiping Li, Bonnie Geld, Roger Y Wu, Paul Visintainer
INTRODUCTION: Because lack of inpatient capacity is associated with emergency department (ED) crowding, more efficient bed management could potentially alleviate this problem. Our goal was to assess the impact of involving a patient placement manager (PPM) early in the decision to hospitalize ED patients. The PPMs are clinically experienced registered nurses trained in the institution-specific criteria for correct unit and bed placement. METHODS: We conducted two pilot studies that included all patients who were admitted to the adult hospital medicine service: 1) 10/24 to 11/22/2010 (30 days); and 2) 5/24 to 7/4/2011 (42 days)...
September 2014: Western Journal of Emergency Medicine
Robert A Barish, Patrick L McGauly, Thomas C Arnold
Emergency room (ER) crowding has become a widespread problem in hospitals across the United States. Two main reasons can be cited. First, emergency medicine is the only specialty in the "House of Medicine" that has a federal mandate to provide care to any patients requesting treatment. Second, primary care providers are in short supply, forcing sick people to seek medical care in ERs. Once seen as an "ER problem," crowding has become more appropriately recognized as a "hospital problem," related to factors beyond the doors of the ER...
2012: Transactions of the American Clinical and Climatological Association
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