scholarly journals Sleep Faster! (Somebody else needs your blanket...)

2012 ◽  
Vol 36 (3) ◽  
pp. 244 ◽  
Author(s):  
Matthew H. R. Anstey ◽  
Stephen P. Gildfind ◽  
Eugene Litvak
Keyword(s):  
Emergency Department ◽  
Health Reform ◽  
Waiting Times ◽  
Alternative Solution ◽  
Inpatient Services ◽  
Reform Plan ◽  
Australian State ◽  
The Uk

One of the elements of the health reform plan, as agreed to by Australian state and federal governments, is to introduce a 4-h National Access Target, to reduce emergency department (ED) waiting times. This article highlights the flawed rationale behind the 4-h rule, the UK experience of this rule and discusses the potential dangers it poses to Australian patients. An alternative solution proposed is the separation of elective and emergency surgical streams to reduce the variability in demand for inpatient services.

Health Reform Plan May Debut This Month

2009 ◽  
Vol 43 (6) ◽  
pp. 7 ◽  
Author(s):  
ALICIA AULT
Keyword(s):  
Health Reform ◽  
Reform Plan

scholarly journals Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110114
Author(s):  
Andrew Nyce ◽  
Snehal Gandhi ◽  
Brian Freeze ◽  
Joshua Bosire ◽  
Terry Ricca ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Experience ◽  
Waiting Times ◽  
Hospital Length ◽  
Short Length ◽  
Hospital Length Of Stay ◽  
Patient’S Experience ◽  
Discharged Patients ◽  
The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

Does a Dedicated Pediatric Team Within a Busy Mixed Emergency Department Make a Difference in Waiting Times, Satisfaction, and Care Transition?

2010 ◽  
Vol 26 (4) ◽  
pp. 274-280 ◽  
Author(s):  
Gerben Keijzers ◽  
Julia Crilly ◽  
Benjamin Walters ◽  
Rosalind Crawford ◽  
Christa Bell
Keyword(s):  
Emergency Department ◽  
Waiting Times ◽  
Care Transition

scholarly journals The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler
Keyword(s):  
United States ◽  
Health Reform ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Reform Plan ◽  
The Difference ◽  
The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

Radiotherapy Dose Fractionation, Access and Waiting Times in the Countries of the UK in 2005

2007 ◽  
Vol 19 (5) ◽  
pp. 273-286 ◽  
Author(s):  
M.V. Williams ◽  
E.T. Summers ◽  
K. Drinkwater ◽  
A. Barrett
Keyword(s):  
Waiting Times ◽  
Dose Fractionation ◽  
The Uk ◽  
Radiotherapy Dose

Validating the primary provider theory in emergency medicine

2008 ◽  
Vol 21 (2) ◽  
pp. 120-130 ◽  
Author(s):  
Joseph S. Guarisco ◽  
Stefoni A. Bavin
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Pay For Performance ◽  
Medical Center ◽  
Waiting Times ◽  
Emergency Department Visits ◽  
Business Success ◽  
Content Type ◽  
The Impact

PurposeThe purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.Design/methodology/approachThe case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.FindingsThe findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.Practical implicationsThese findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.Originality/valueThere are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

scholarly journals Demographic and clinical characteristics of traumatic shoulder dislocations in an eastern Anatolian city in Turkey: A retrospective single-centre analysis of 181 patients

2021 ◽  
Vol 8 (5) ◽  
pp. 298-305
Author(s):  
Ömer Cengiz ◽  
Ferdi Dırvar
Keyword(s):  
Emergency Department ◽  
Shoulder Dislocation ◽  
Clinical Characteristics ◽  
Sports Injuries ◽  
Age Distribution ◽  
Mechanism Of Injury ◽  
Single Centre ◽  
Patient Database ◽  
The Usa ◽  
The Uk

Objective: This study aims to investigate demographic and clinical characteristics of traumatic shoulder dislocations in an Eastern Anatolian city (Muş) in Turkey. Material and Methods: Digital patient database was reviewed to identify the glenohumeral shoulder dislocations admitted to the emergency department between January 2017 and December 2018. Incidence, demographics, recurrence, associated injuries, and mechanism of injury were evaluated. Results: One hundred and eighty-one patients (140 males, 41 females; mean age: 39.98±20.41 years) experienced traumatic shoulder dislocation during the study period. The incidence was 18,9 per 100,000 person-years. Age distribution peaked between 21 and 30 (94.5% male) and between 61 and 70 years. Primary shoulder dislocation occurred in 153, recurrent dislocations in 28, and anterior dislocations in 177 patients. The mechanism of injury included falls in 144 and sports injuries in 18 cases. The reduction was achieved in 154 patients in the emergency department. Conclusion: The incidence of traumatic shoulder dislocations in Muş was higher than the study conducted in Turkey but similar to those in Europe, the UK, and the USA. Risk factors included young age (21-40) and participation in sports in men but fall and being in the 6th decade in women.

scholarly journals Peripheral Intravenous Cannula Usage in the Emergency Department

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Adam K Stanley ◽  
Ashton Barnett-Vanes ◽  
Matthew J Reed
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Regional Variation ◽  
Evidence Based ◽  
Failure Rates ◽  
Intravenous Cannula ◽  
Hospitalised Patients ◽  
The Uk ◽  
Evidence Based Guidelines

Over a billion Peripheral Intra-Venous Cannulas (PIVC) are used globally every year with at least 25 million sold annually in the UK.1,2 The NHS spends an estimated £29m of its annual acute sector budget on PIVC procurement3 and around 70% of all hospitalised patients require at least one PIVC during their stay.4 Despite their extensive and routine use, PIVC failure rates are reported as high as 50-69%.5-7 In addition, many PIVCs remain unused following insertion, particularly in the Emergency Department (ED).8,9 The risk factors for PIVC failure are not well understood and the literature has found extensive regional variation in practice when it comes to PIVC insertion and management.1,7,10 While various technologies have been developed to address these issues, there remains a need for standardised, evidence-based guidelines.

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