Oct 15 2020
Critical Care Boarding in the ER: Complicated Problem, Bad Outcomes
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ED boarding of critically ill patients is common and is associated with worse clinical outcomes: increased duration of mechanical ventilation, increased probability of poor neurologic outcome, longer ICU length of stay, and higher in-hospital mortality. This a systemic problem with no easy fix.
Aug 25 2020
Advanced Practice Clinicians and Emergency Department Flow
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We need to closely examine how best to utilize advanced practice providers (APPs) in our ED staffing models. In settings where APPs are treating lower complexity patients, APP coverage does not have a negative impact on clinical quality or patient experience. Authors noted higher APP coverage allowed physicians to see higher acuity cases but did not seem to lower staffing costs.
Aug 10 2020
Do Point-of-Care Tests Fix Overcrowding?
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Emergency department length of stay was no different with point-of-care (POC) lab testing in the ED vs central lab processing, despite a significant drop in lab turnaround time (51 minutes faster with POC).
May 05 2020
Emergency Physician-Driven Admission Decisions Reduce Crowding
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Emergency physician determination of the need for admission, vs. getting approval from a consultant first, was extremely accurate and would have significantly reduced ED wait times and crowding.
May 01 2020
Ten Ways to Improve Physician-Nurse Communication
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Successful communication between emergency physicians and nurses requires strategies to improve knowledge sharing, streamlining plan of care, acknowledging patient status changes, and awareness of team dynamics.
Feb 27 2020
Does Prolonged Disposition Time Increase Mortality?
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Time to ED disposition ≥4 hours was associated with increased 30-day mortality. This was more likely in complex patients or those being admitted to psychiatric, surgical, or oncology services.
Feb 26 2020
How Not to Handle Frequent Flyers
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Deploying a team of healthcare professionals to assist patients with complex medical and social needs at hospital discharge did not reduce readmission rate.
Dec 10 2019
Medication Assisted Treatment in a Community Emergency Dept.
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style="white-space:pre-wrap;">In this community ED, patients were given immediate buprenorphine and rapid outpatient follow up at a substance abuse treatment facility. This led to high rates of follow up and appeared feasible in this setting.
Dec 05 2019
Rapid Assessment Zone – No Triage
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style="white-space:pre-wrap;">A rapid assessment zone of ambulatory patients without initial traditional triage resulted in significant patient flow improvements.
Nov 08 2019
Is the 1-Hour Sepsis Mandate Doable?
Despite a QI initiative for an ED-wide sepsis screening protocol and individual clinician feedback, this center was not able to meet the new Surviving Sepsis 1-hour antibiotic metric most of the time.