Some Patients Can’t Wait: Improving Timeliness of Emergency Department Care

AORN Journal ◽  
2021 ◽  
Vol 114 (2) ◽  
pp. 211-213
Keyword(s):  
Emergency Department ◽  
Emergency Department Care

scholarly journals National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Akshay Pendyal ◽  
Craig Rothenberg ◽  
Jean E. Scofi ◽  
Harlan M. Krumholz ◽  
Basmah Safdar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Length Of Stay ◽  
Real World ◽  
The United States ◽  
Emergency Department Care ◽  
Care Processes ◽  
Ed Visits

Background Despite investments to improve quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real‐world trends in AMI care in the emergency department (ED). We aimed to describe trends in the epidemiology and quality of AMI care in US EDs over a recent 11‐year period, from 2005 to 2015. Methods and Results We conducted an observational study of ED visits for AMI using the National Hospital Ambulatory Medical Care Survey, a nationally representative probability sample of US EDs. AMI visits were classified as ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI. Outcomes included annual incidence of AMI, median ED length of stay, ED disposition type, and ED administration of evidence‐based medications. Annual ED visits for AMI decreased from 1 493 145 in 2005 to 581 924 in 2015. Estimated yearly incidence of ED visits for STEMI decreased from 1 402 768 to 315 813. The proportion of STEMI sent for immediate, same‐hospital catheterization increased from 12% to 37%. Among patients with STEMI sent directly for catheterization, median ED length of stay decreased from 62 to 37 minutes. ED administration of antithrombotic and nonaspirin antiplatelet agents rose for STEMI (23%–31% and 10%–27%, respectively). Conclusions National, real‐world trends in the epidemiology of AMI in the ED parallel those of clinical registries, with decreases in AMI incidence and STEMI proportion. ED care processes for STEMI mirror evolving guidelines that favor high‐intensity antiplatelet therapy, early invasive strategies, and regionalization of care.

Assessment of a multi-center tele-urgent care program to decrease emergency department referral rates in the Veterans Health Administration

2021 ◽  
pp. 1357633X2110248
Author(s):  
Charlie M Wray ◽  
Myla Junge ◽  
Salomeh Keyhani ◽  
Janeen E Smith
Keyword(s):  
Emergency Department ◽  
Emergency Department Visit ◽  
Care Program ◽  
Urgent Care ◽  
Emergency Department Utilization ◽  
Emergency Department Care ◽  
Referral Rates ◽  
Care Assessment ◽  
The Impact ◽  
Care Evaluation

The use of emergency departments for non-emergent issues has led to overcrowding and decreased the quality of care. Telemedicine may be a mechanism to decrease overutilization of this expensive resource. From April to September 2020, we assessed (a) the impact of a multi-center tele-urgent care program on emergency department referral rates and (b) the proportion of individuals who had a subsequent emergency department visit within 72 h of tele-urgent care evaluation when they were not referred to the emergency department. We then performed a chart review to assess whether patients presented to the emergency department for the same reason as was stated for their tele-urgent care evaluation, whether subsequent hospitalization was needed during that emergency department visit, and whether death occurred. Among the 2510 patients who would have been referred to in-person emergency department care, but instead received tele-urgent care assessment, one in five (21%; n = 533) were subsequently referred to the emergency department. Among those not referred following tele-urgent care, 1 in 10 (11%; n = 162) visited the emergency department within 72 h. Among these 162 individuals, most (91%) returned with the same or similar complaint as what was assessed during their tele-urgent care visit, with one in five requiring hospitalization (19%, n = 31) with one individual (0.01%) dying. In conclusion, tele-urgent care may safely decrease emergency department utilization.

scholarly journals Navigating the Boundaries of Emergency Department Care: Addressing the Medical and Social Needs of Patients Who Are Homeless

2013 ◽  
Vol 103 (S2) ◽  
pp. S355-S360 ◽  
Author(s):  
Kelly M. Doran ◽  
Anita A. Vashi ◽  
Stephanie Platis ◽  
Leslie A. Curry ◽  
Michael Rowe ◽  
...  
Keyword(s):  
Emergency Department ◽  
Social Needs ◽  
Emergency Department Care

scholarly journals ‘I'll be in a safe place’: a qualitative study of the decisions taken by people with advanced cancer to seek emergency department care

BMJ Open ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. e012134 ◽  
Author(s):  
Lesley A Henson ◽  
Irene J Higginson ◽  
Barbara A Daveson ◽  
Clare Ellis-Smith ◽  
Jonathan Koffman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Qualitative Study ◽  
Advanced Cancer ◽  
Emergency Department Care ◽  
Safe Place

Tracking the Rise of Geriatric Emergency Departments in the United States

2018 ◽  
Vol 39 (8) ◽  
pp. 871-879 ◽  
Author(s):  
John G. Schumacher ◽  
Jon Mark Hirshon ◽  
Phillip Magidson ◽  
Marilyn Chrisman ◽  
Terisita Hogan
Keyword(s):  
Emergency Department ◽  
Emergency Care ◽  
Emergency Departments ◽  
The United States ◽  
Transitions Of Care ◽  
Emergency Department Care ◽  
Equipment And Supplies ◽  
Care Services ◽  
Physical Environments

The traditional model of emergency care no longer fits the growing needs of the over 20 million older adults annually seeking emergency department care. In 2007 a tailored “geriatric emergency department” model was introduced and rapidly replicated among hospitals, rising steeply over the past 5 years. This survey examined all U.S. emergency departments self-identifying themselves as Geriatric Emergency Departments (GEDs) and providing enhanced geriatric emergency care services. It was guided by the recently adopted Geriatric Emergency Department Guidelines and examined domains including, GED identity, staffing, and administration; education, equipment, and supplies; policies, procedures, and protocols; follow-up and transitions of care; and quality improvement. Results reveal a heterogeneous mix of GED staffing, procedures, physical environments and that GEDs’ familiarity with the GED Guidelines is low. Findings will inform emergency departments and gerontologists nationwide about key GED model elements and will help hospitals to improve ED services for their older adult patients.

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