scholarly journals Acute care of older patients in the emergency department: strategies to improve patient outcomes

2015 ◽  
pp. 45 ◽  
Author(s):  
Sean Kennelly ◽  
John Joseph McCabe
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Patient Outcomes ◽  
Older Patients ◽  
Improve Patient

scholarly journals Can an emergency department clinical “triggers” program based on abnormal vital signs improve patient outcomes? – CORRIGENDUM

CJEM ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 80-80
Author(s):  
Jason Imperato ◽  
Tyler Mehegan ◽  
Daniel J. Henning ◽  
John Patrick ◽  
Chase Bushey ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Outcomes ◽  
Vital Signs ◽  
Improve Patient

scholarly journals Older Patients’ Perspectives on Factors Contributing to Frequent Visits to the Emergency Department: A Qualitative Interview Study

2020 ◽  
Author(s):  
Daisy Kolk ◽  
Anton F. Kruiswijk ◽  
Janet L. MacNeil-Vroomen ◽  
Milan L. Ridderikhof ◽  
Bianca M. Buurman
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Older Patients ◽  
Structured Interviews ◽  
Post Discharge ◽  
Qualitative Interview Study ◽  
Before And After ◽  
Ed Visits ◽  
The Relationship

Abstract Background: Older patients are at high risk of unplanned revisits to the emergency department (ED) because of their medical complexity. To reduce the number of ED visits, we need more knowledge about the patient-level, environmental, and healthcare factors involved. The aim of this study was to collect older patients’ perspectives and experiences before and after an ED visit, and to identify factors that possibly contribute to frequent ED revisits.Methods: We performed semi-structured interviews with older patients who frequently visited the ED and were discharged home after an acute visit. Patients were enrolled in the ED of a university medical centre using purposive sampling to achieve maximum variation in heterogeneity. Interviews were recorded, transcribed, and coded independently by two researchers. Theoretical analysis was used to identify recurring patterns and themes in the data. Interviews were conducted until thematic saturation was reached.Results: In-depth interviews were completed with 13 older patients. Three main themes emerged: 1) medical events leading to feelings of crisis, 2) patients’ untreated health problems, and 3) persistent problems in health and daily functioning post discharge. Participants identified problems before and after their ED visit that possibly contributed to further ED visits. These problems included increasing symptoms leading to feelings of crisis, the relationship with the general practitioner, incomplete discharge information at the ED, and inadequate follow-up and lack of recovery after an ED visit.Conclusions: This qualitative study identified multiple factors that may contribute to frequent ED visits among older patients. Older patients in need of acute care might benefit from hospital-at-home interventions, or acute care provided by geriatric emergency teams in the primary care setting. Identifying frailty in the ED is needed to improve discharge communication and adequate follow-up is needed to improve recovery after an acute ED visit.

scholarly journals 135 The Impact of an Early Mobilisation Initiative Evidence from an Acute Care Setting

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Aileen Horgan ◽  
Michelle Carr ◽  
Aileen Murphy
Keyword(s):  
Acute Care ◽  
Patient Outcomes ◽  
Care Setting ◽  
Functional Decline ◽  
Length Of Hospital Stay ◽  
Hospital Length Of Stay ◽  
Acute Care Setting ◽  
Early Mobilisation ◽  
The Impact ◽  
Improve Patient

Abstract Background Unnecessary bed rest results in a loss of mobility and an increased length of hospital stay. Despite mobilising regularly being acknowledged as an important preventative measure for deconditioning, inpatient functional decline continues to pose a significant challenge in hospital settings. Hospital-based mobility initiatives offer the potential to address issues of functional decline, improve patient outcomes and hospital length of stay. The aim of this research is to examine the impact of an early mobilisation initiative called “End PJ Paralysis”. Methods The research design comprises of three elements: (i) an examination of a period that promoted mobility to all patients on one acute unit (ii) an analysis of the reported number of falls during the study period and (iii) an exploration of perceptions and attitudes of nurses, nurse managers, and patients involved with the initiative. Results Our study demonstrates that following a 10-week promotion of the initiative from April 17th-June 26th 2018 in an acute care setting in south of Ireland, an increase of 15% of patients were mobilising and a decrease in the number of reported falls. In addition, staff participation was found to increase and self-reported patient satisfaction improved. Factors identified as influencing the impact of the initiative included patient and staff behavior, nurse management leadership, and effective communication. Conclusion The study provides evidence to suggest that early mobilisation initiatives can prevent deconditioning and improve patient outcomes. Each day a patient spends in hospital should contribute towards their recovery and discharge and mobilising patients while in hospital has a profound impact on their functional status.

Getting It Right First Time: the reports

2021 ◽  
Vol 17 (6) ◽  
pp. 247-252
Author(s):  
Sue Thomas
Keyword(s):  
Quality Improvement ◽  
Service Delivery ◽  
Acute Care ◽  
Patient Outcomes ◽  
Future Directions ◽  
Subject Areas ◽  
First Time ◽  
Improve Patient

Originally launched in 2015, the Getting It Right First Time (GIRFT) programme has become a leading authority for quality improvement in the NHS. In September 2021, the programme published an impressive series of reviews in no fewer than 18 subject areas, neurology being one of these. While earlier GIRFT reports tended to focus on acute care, the new reports have a much wider scope and scan a whole pathway approach for unwarranted variations in practice and what needs to happen to improve patient outcomes. In Part 1, Sue Thomas explores what GIRFT says about the organisation of neurological services and recommendations for service delivery, while Part 2 will explore parallel services, commissioning and future directions.

Implementing Point-of-Care Testing in the Emergency Department to Improve Patient Outcomes

2008 ◽  
Vol 7 (3) ◽  
pp. 143
Author(s):  
Elizabeth-Lee Lewandrowski ◽  
James Flood ◽  
Donna MacMillan ◽  
Leonard Tochka ◽  
Kent Lewandrowski
Keyword(s):  
Emergency Department ◽  
Patient Outcomes ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Improve Patient

scholarly journals Ultrasound Utility in the Diagnosis of a Morel-Lavallée Lesion

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Scott LaTulip ◽  
Rameshwar R. Rao ◽  
Alan Sielaff ◽  
Nik Theyyunni ◽  
John Burkhardt
Keyword(s):  
Emergency Department ◽  
Patient Outcomes ◽  
Imaging Technique ◽  
Point Of Care ◽  
Cost Effective ◽  
Rapid Diagnosis ◽  
Point Of Care Ultrasound ◽  
Ultrasound Findings ◽  
Specialized Equipment ◽  
Improve Patient

Morel-Lavallée lesions are uncommon injuries that can be associated with significant comorbidities if not detected early. Rapid diagnosis in the Emergency Department could significantly improve patient outcomes. We describe the diagnosis of such a lesion through the use of ultrasound imaging in the Emergency Department to utilize a fast, cost-effective imaging technique that does not subject the patient to radiation exposure. Our patient received surgical consultation but improved with conservative management. Ultrasound findings associated with this lesion do not require specialized equipment and should be considered when evaluating soft tissue lesions using point of care ultrasound.

scholarly journals Older patients’ perspectives on factors contributing to frequent visits to the emergency department: a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daisy Kolk ◽  
Anton F. Kruiswijk ◽  
Janet L. MacNeil-Vroomen ◽  
Milan L. Ridderikhof ◽  
Bianca M. Buurman
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Older Patients ◽  
Qualitative Description ◽  
Post Discharge ◽  
Individual Interviews ◽  
Qualitative Interview Study ◽  
Before And After ◽  
Ed Visits

Abstract Background Older patients are at high risk of unplanned revisits to the emergency department (ED) because of their medical complexity. To reduce the number of ED visits, we need more knowledge about the patient-level, environmental, and healthcare factors involved. The aim of this study was to describe older patients’ perspectives and experiences before and after an ED visit, and to identify factors that possibly contribute to frequent ED revisits. Methods This was a qualitative description study. We performed semi-structured individual interviews with older patients who frequently visited the ED and were discharged home after an acute visit. Patients were enrolled in the ED of a university medical centre using purposive sampling. Interviews were recorded, transcribed, and coded independently by two researchers. Theoretical analysis was used to identify recurring patterns and themes in the data. Interviews were conducted until thematic saturation was reached. Results In-depth interviews were completed with 13 older patients. Three main themes emerged: 1) medical events leading to feelings of crisis, 2) patients’ untreated health problems, and 3) persistent problems in health and daily functioning post discharge. Participants identified problems before and after their ED visit that possibly contributed to further ED visits. These problems included increasing symptoms leading to feelings of crisis, the relationship with the general practitioner, incomplete discharge information at the ED, and inadequate follow-up and lack of recovery after an ED visit. Conclusions This qualitative study identified multiple factors that may contribute to frequent ED visits among older patients. Older patients in need of acute care might benefit from hospital-at-home interventions, or acute care provided by geriatric emergency teams in the primary care setting. Identifying frailty in the ED is needed to improve discharge communication and adequate follow-up is needed to improve recovery after an acute ED visit.

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