Health care in the emergency room: An analysis of patient and staff attitudes

1976 ◽  
Author(s):  
M. M. Zajkowski ◽  
D. Afimiwala
Keyword(s):  
Health Care ◽  
Emergency Room ◽  
Staff Attitudes

Health Care in the Emergency Room: An Analysis of Patient and Staff Attitudes

1976 ◽  
Vol 20 (4) ◽  
pp. 77-82
Author(s):  
M. M. Zajkowski ◽  
D. Afimiwala
Keyword(s):  
Health Care ◽  
Emergency Room ◽  
Waiting Time ◽  
Staff Attitudes ◽  
Emergency Rooms ◽  
Personal Physician ◽  
Teaching Cases ◽  
Evaluation Of Care

The purpose of the investigation was to identify and analyze problems and attitudes which may contribute to the perceived quality of health care in the emergency room. To assess the extent of these problems a 51-item questionnaire was administered in the emergency rooms of two major hospitals. Questionnaires were distributed to Physicians, Nurses, Technicians, and Patients. Results revealed significant differences between patients and staff attitudes toward the emergency status of most patients, the types of illnesses appropriate to the emergency room, treatment for belligerents (in no serious danger), special training of M.D.'s for emergency room duty, the types of patients treated as teaching cases, the major causes of waiting time, types of patients who receive the most and least time in actual treatments, waiting time for various services, types of patients who receive the most and least care, and time spent in treatment and its association with quality of care. Similarities in patient and staff attitudes were found in attitudes towards sources of referral, availability of personal physician, appropriate patient behavior at various stages of diagnosis and/or care, role of the receptionist, ordering of treatment as a function of urgency of the illness, role of communication between doctor and patient, acceptable waiting time before seeing physician, costs associated with care, evaluation of care provided by physicians and nurses, and reimbursement of costs as a function of source of payment.

scholarly journals ACOLHIMENTO COM AVALIAÇÃO E CLASSIFICAÇÃO DE RISCO DE UM PRONTO ATENDIMENTO: CARACTERIZAÇÃO DOS ATENDIMENTOS

2020 ◽  
Vol 3 (6) ◽  
pp. 1-10
Author(s):  
Luriely Rosa Batista JAQUES ◽  
Priscila de Oliveira B. da SILVA ◽  
Maria Eduarda de O. BORGES ◽  
Thalis Murilo PUGLIA ◽  
Carmem Costa MARTINS ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Room ◽  
Quantitative Research ◽  
Quality Care ◽  
Risk Classification ◽  
Health Care Needs ◽  
Emergency Rooms ◽  
Care Needs ◽  
Female Age ◽  
Care Assistance

O presente estudo teve como objetivo caracterizar os atendimentos realizados no Pronto Atendimento de um hospital do interior paulista, segundo o protocolo de acolhimento com avaliação de classificação de risco. Trata-se de uma pesquisa descritiva e quantitativa, baseada em dados secundários, obtidos na Ficha de Atendimento (FA) de uma unidade de Pronto Atendimento (PA). A maior parte dos usuários atendidos no PA é do sexo feminino, com faixa etária de 0-10 e 31-40 anos. O período de maiores atendimentos realizados pelo serviço foi das 18:01-21:00 horas, seguido do horário das 15:01-18:00 horas.  A classificação de risco que mais se evidenciou no presente estudo foram as cores verde e azul. A população tem procurado utilizar o PA como porta de entrada ao serviço de saúde. Isso demonstra que o fluxo entre os níveis de assistência à saúde deve ser melhor estruturado. Os dados podem servir para melhorar o cuidado com qualidade, direcionando-o para as necessidades de saúde da população, uma vez que se conhecem as características dos pacientes atendidos no Pronto Atendimento.   ASSESSMENT AND RISK CLASSIFICATION RECEPTION AT A MEDICAL CARE UNIT: SERVICES CATEGORIZATION   ABSTRACT The present study aims at categorizing medical services in an Emergency Room in a hospital at Paulista countryside in line with the reception protocol for assessment and risk classification. It is a case of descriptive and quantitative research based on a secondary database, obtained from Medical Charts (MC) at an Emergency Room (ER). Most of the patients assisted at the ER were female; age ranged from 0-10 and 31-40 years old. Most of the procedures were performed from 6:01 pm. to 9 pm., followed by 3:01 pm. to 6 pm. In the present study, green and blue risk classifications were the most frequent. People have seen the ER as an entry point for health care assistance, evidencing that the flow among assistance levels must have a better organization. Data might be useful to improve quality care, meeting people’s health care needs since the characteristics of the patients who are assisted by Emergency Rooms are known.   Descriptors:  Reception. Classification. Emergency Nursing.

Analysis of Emergency Room Visits Reveals a Seriously Mentally Ill, Medically Fragile Population Requiring Strategic Management

2019 ◽  
Vol 25 (6) ◽  
pp. 496-500
Author(s):  
Kavinder Sahota ◽  
Carole Bennett
Keyword(s):  
Health Care ◽  
Emergency Room ◽  
Mentally Ill ◽  
Health Care Services ◽  
Physical Symptoms ◽  
Medically Fragile ◽  
Integration Of Care ◽  
Improvement Project ◽  
Care Services ◽  
Seriously Mentally Ill

OBJECTIVE: This practice improvement project evaluated the cost of health care services utilized by patients with comorbid mental and physical chronic conditions who were psychiatrically hospitalized but transported for health care services of physical symptoms that developed during their psychiatric hospitalization. METHOD: A retrospective review of invoices to a regional psychiatric hospital for non-psychiatric health services utilized by inpatients revealed high costs of emergency room (ER) visits from July 2016 to June 2017. Medical records for these seriously mentally ill inpatients who visited the ER for evaluation of sudden emergent physical symptoms were reviewed. The collected data were analyzed. RESULTS: ER invoices revealed that 41 visits had been made by 28 patients with a total cost of $308,466.67, of which $258,668.15 was judged to be for the treatment of patients with symptoms of preventable side effect syndromes. This chart review and analysis suggest a need for improved strategic medication management in an integrated model of care. CONCLUSIONS: Polypharmacy was found to be responsible for increased debilitating physical symptoms requiring ER visits for this seriously mentally ill, medically fragile population. An integration of care services for comorbid conditions by advanced practice registered nurses with protocols specifically designed for this population was recommended.

Encouraging Self—Care within a Primary Health Care Framework

2007 ◽  
Vol 20 (2) ◽  
pp. 28-33 ◽  
Author(s):  
Mary Lou O'Neill ◽  
Evelyn Kennedy ◽  
Cyndee MacPhee
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Emergency Room ◽  
Self Care ◽  
Health Problems ◽  
Perceived Usefulness ◽  
Emergency Room Visits ◽  
Primary Health ◽  
Study Results

This study was undertaken primarily to evaluate Do I Need to See the Doctor?, a book designed to assist young families to self-manage common health problems. In addition, the study sought to determine whether providing an introductory explanation to the book had an impact on the respondents' perceived usefulness of it. Comparisons of emergency room visits were made for the timeframe of the study and for the previous year. Study results support the book's usefulness in increasing respondents' confidence to make knowledgeable, informed self-care decisions. Providing explanations did not affect the book's usefulness. A link between emergency room visits and the book requires further study.

Health-Care Staff Attitudes Towards Self-Harm Patients

2010 ◽  
Vol 44 (8) ◽  
pp. 713-720 ◽  
Author(s):  
Sheree J. Gibb ◽  
Annette L. Beautrais ◽  
Lois J. Surgenor
Keyword(s):  
Health Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Staff Attitudes ◽  
Self Harm

Early use of home health care on health care utilization for patients with advanced lung cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19015-e19015
Author(s):  
Steven Rousey ◽  
Kiran Krishan Lassi ◽  
Jodi Wieczorek ◽  
James Essler ◽  
Marie Brown ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Home Care ◽  
Emergency Room ◽  
Home Health Care ◽  
Home Health ◽  
Advanced Lung Cancer ◽  
Control Group ◽  
Emergency Room Visits ◽  
Early Use

e19015 Background: Patients with advanced lung cancer historically have required significant use of health care resources including hospitalizations, ICU admissions and emergency room visits which are often related to inadequately controlled symptoms. Most patients with advanced lung cancer prefer to remain in their own home as much as possible and are willing to work with home nursing resources, if available. The purpose of this pilot study was to determine the effect of early use of home health care on health care utilization for patients with advanced lung cancer. Methods: Betweem May 2011 and May 2012, 18 patients were enrolled in a pilot program to explore early use of home care for individuals with advanced lung cancer. Inclusion criteria consisted of a diagnosis of stage III/IV lung cancer (any histology) and home care eligibility using Medicare criteria. The endpoints were hospitalization rate, number of ICU admissions and emergency room visits. The results were compared to an historical control group (562 patients with advanced lung cancer diagnosed between 2006 and 2011). Binomial confidence interval (CI) was used to estimate the 95% CIs and Fisher's exact test was used to assess the p-values. Results: Results at one year showed the hospitalization rates for the pilot group and the control group were 44% (95% CI, 22-69) and 78% (95% CI, 74-81), respectively (p<0.01) and the ER visit rate was 17% (95% CI, 4-41) and 41% (95% CI, 37-45), respectively (p=0.049). The ICU admission rates were 0% and 11% in the two groups, respectively, and this difference was not statistically significant. Home care visits ranged from 1-77 with an average of 12 visits per patient. The estimated cost of the home care program for the duration of enrollment was $2,330 per patient. Conclusions: Early use of home health care for patients with advanced lung cancer appears to reduce the rates of hospitalization and emergency room visits when compared with historical controls, and though the results were not statistically significant, none of the 18 patients in the pilot group were admitted to the ICU. A larger multi-institutional study will examine the potential of this simple intervention for cost saving, enhanced care quality and improved patient satisfaction.

Emergency Room Use by Low Income Children with a Regular Source of Health Care

Medical Care ◽  
1991 ◽  
Vol 29 (3) ◽  
pp. 283-286 ◽  
Author(s):  
Suezanne T. Orr ◽  
Evan Charney ◽  
John Straus ◽  
Barbara Bloom
Keyword(s):  
Health Care ◽  
Emergency Room ◽  
Low Income ◽  
Low Income Children ◽  
Regular Source

scholarly journals Increased Health Care Cost Associated with Venous Thromboembolism in Patients with Malignant Glioma

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3524-3524
Author(s):  
Heather Wright ◽  
Chris E. Holmes ◽  
Alissa Thomas
Keyword(s):  
Health Care ◽  
Venous Thromboembolism ◽  
Emergency Room ◽  
Malignant Glioma ◽  
Emergency Room Visits ◽  
Total Cost ◽  
Therapeutic Anticoagulation ◽  
Increased Risk ◽  
Inpatient Hospitalizations ◽  
Cancer Types

Abstract Background: The cumulative incidence of symptomatic venous thromboembolism (VTE) among patients with malignant glioma (MG) is high, with estimates ranging from 20-35% during the course of therapy. VTE is the second leading cause of death among ambulatory patients receiving cancer chemotherapy, with a 2-fold or greater increase in mortality compared to those without VTE, even after adjusting for stage. In patients with MG and VTE the chance of two-year survival is significantly reduced. The development of VTE is also associated with increased morbidity, including increased risk of hospitalization, delays in cancer treatment, and an increased risk of complications including pain, bleeding, and bruising from high dose therapeutic anticoagulation. The economic burden of VTE in cancer patients is estimated at a 2-fold increase in cost. Data regarding VTE burden encompasses all cancer types and additional data is needed to characterize VTE burden in specific cancer types, particularly rarer cancers. The aim of this study was to assess the healthcare burden associated with the development of VTE in patients with MG. Methods: A retrospective chart review of patients with MG at an academic medical center was conducted from 2009-2017. Sixty-seven patients, age 18 years and older, with a histologic diagnosis of MG (WHO grade III-IV) were assessed. The number of office visits, emergency room visits, and inpatient hospitalizations with the associated costs of VTE management and its complications were collected. Using SPSS, linear regression models and descriptive statistics were used to determine the relationship between the development of VTE and healthcare consumption. Results: Of the 67 patients in the study, 18 developed VTE (27%). All patients who developed a VTE were placed on therapeutic anticoagulation. Fifty percent of patients developed complications related to anticoagulation, including gastrointestinal, retroperitoneal and intracranial bleeding events. Two patients required placement of an IVC filter after experiencing a bleeding complication. Patients that developed VTE had an increase in inpatient days (16.6 inpatient days) as compared to their non-VTE counterparts (8.8 inpatient days), (p=0.012). There was increased utilization of the emergency room with an average of 3.94 visits in those patients with VTE as compared to those without (1.84), (p=0.003). A full cost analysis found that the average primary total cost for ED visits and inpatient hospitalizations in patients with VTE was $48,863 while those without VTE averaged $35,948. This represented a 26% increase in the average primary total cost in those patients with VTE. Discussion: The development of VTE in patients with MG increases inpatient admissions days and incurs additional pharmaceutical costs related to anticoagulation. This study represents the first assessment of VTE-associated health care burden specific to primary brain cancer. We confirm that VTE affects a large number of patients with MG (27%) and limits the time spent at home due to increased hospitalizations and emergency room visits. VTE may be a preventable complication and further studies are needed to investigate safe prevention strategies for patients with MG. Disclosures No relevant conflicts of interest to declare.

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