Could Teleconsultation Reduce Pediatric Transfers?
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This retrospective study found that of the 4,446 patients transferred over a 4.5-year period, 1,509 (34%) transfers could have possibly been avoided by utilizing telehealth/teleconsultation, with the most common transfer complaints being abdominal pain, asthma, and cough.
Source
Pediatric Patients Discharged After Transfer to a Pediatric Emergency Department: Opportunities for Telehealth?. Ann Emerg Med. 2024;83(3):208-213. doi:10.1016/j.annemergmed.2023.08.489
Conservative or Cowboy – Does Risk Tolerance Impact Admission Rate?
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In this retrospective study of ED physicians in one state, researchers found statistically significant differences in admission rates among clinicians but little consistency in admission tendencies across multiple conditions. Clinicians with greater tolerance to risk (as a general attitude) had associated lower rates of admission when compared to projections.
Source
Clinician Risk Tolerance and Rates of Admission From the Emergency Department. JAMA Netw Open. 2024 Feb 5;7(2):e2356189. doi: 10.1001/jamanetworkopen.2023.56189.
Inequities in Hallway Bed Placement
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In the absence of a standardized approach, patients placed in hallway beds were more likely to be male, have Medicaid/self-pay payer status, and elope in this single health system study.
Source
Inequities among patient placement in emergency department hallway treatment spaces. Am J Emerg Med. 2024 Feb;76:70-74. doi: 10.1016/j.ajem.2023.11.013. Epub 2023 Nov 11.
Making PROGRESS – Pediatric Emergencies and Healthcare Disparities
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This systematic review and meta-analysis identified multiple social determinants of health that were related to increased utilization of ED services by children from racial minority and lower socioeconomic status (SES) groups.
Source
Social Determinants of Health and Pediatric Emergency Department Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Ann Emerg Med. Published online December 6, 2023. doi:10.1016/j.annemergmed.2023.10.010
Simplest Way to Boost Patient Satisfaction? You Might Want to Sit Down for This…
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Chair placement near the bedside is a simple intervention that increased the likelihood of physician sitting during patient encounters and yielded higher patient scores in satisfaction and communication.
Source
Effect of chair placement on physicians' behavior and patients' satisfaction: randomized deception trial. BMJ. 2023;383:e076309. Published 2023 Dec 15. doi:10.1136/bmj-2023-076309.
The Real Risks of Boarding in the Emergency Department
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In this large, multicenter prospective cohort study in France, researchers found that patients ≥75 years who were admitted overnight boarding in the ED had higher rates of in-hospital mortality, length of stay, and adverse events.
Source
Overnight Stay in the Emergency Department and Mortality in Older Patients. JAMA Intern Med. 2023 Dec 1;183(12):1378-1385. doi: 10.1001/jamainternmed.2023.5961.
Does Contact Precaution for MRSA Really Matter?
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Contact precaution (CP) for patients with MRSA infection or colonization is listed as an "essential practice" for all U.S. hospitals, but should it be?
Experienced or Rusty? Physician Age and Patient Mortality
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Emergency physician (EP) advancing age was associated with higher 7-day patient mortality. This is a call to keep current with literature, clinical skills, and best practices.
Source
Association Between Emergency Physician's Age and Mortality of Medicare Patients Aged 65 to 89 Years After Emergency Department Visit. Ann Emerg Med. 2023 Sep;82(3):301-312. doi: 10.1016/j.annemergmed.2023.02.010. Epub 2023 Mar 23.
Who Gets Sued in EM – NP, PA, Attending, or Resident?
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In a retrospective analysis of 5,854 emergency department malpractice cases from over 550 US hospitals, 193 (3.3%) involved an NP, 513 (8.8%) involved a PA, 535 (9.1%) involved a trainee, and 4,568 (78.0%) were attending only.
Source
Characterizing malpractice cases involving emergency department advanced practice providers, physicians in training, and attending physicians [published online ahead of print, 2023 Sep 8]. Acad Emerg Med. 2023;10.1111/acem.14800.
How to Identify Errors – “Would You Have Done Something Differently?”
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Asking EPs the question - “Would you have done something differently? (WYHDSD)” - was found to have high sensitivity (97.4%) and NPV (99.8%) in predicting medical error. Specificity was lower at 92.9%.
Source
Can Asking Emergency Physicians Whether or Not They Would Have Done Something Differently (WYHDSD) be a Useful Screening Tool to Identify Emergency Department Error? J Emerg Med. 2023 Sep;65(3):e250-e255. doi: 10.1016/j.jemermed.2023.05.005. Epub 2023 Jun 10.