Background:With increased emphasis on improving the patient experience, clinicians are being asked to improve their patient-centered communication behaviors to improve patient satisfaction (PS) scores.Local Problem:The relationship between clinician communication behaviors and PS is poorly studied in the emergency department (ED) setting. The purpose of this study was to identify whether specific communication behaviors correlate with higher PS scores in the ED setting.Methods:During a quality improvement project, we performed 191 bedside observations of ED clinicians during their initial interaction with patients and recorded the frequency of 8 positive communication behaviors as defined by the PatientSET tool.Interventions:The frequency of use of the PatientSET communication behaviors was compared between known high performers in Press Ganey PS scores versus low performers.Results:Being a high Press Ganey performer was associated with a significantly higher frequency of performance in 6 of the 8 PatientSET communication behaviors.Conclusions:Positive communication behaviors such as those in the PatientSET tool occurred more frequently in ED clinicians with higher PS scores.
Introduction: The novel coronavirus (COVID-19) pandemic has led to an increase in the number of patients presenting to the emergency department (ED) with severe hypoxia and acute respiratory distress. With limited resources and ventilators available, emergency physicians working at a hospital within the epicenter of the United States outbreak developed a stepwise, non-invasive oxygenation strategy for treating COVID-19 patients presenting with severe hypoxia and acute respiratory distress.
Case Report: A 72-year-old male suspected of having the COVID-19 virus presented to the ED with shortness of breath. He was found to be severely tachypneic, febrile, with rales in all lung fields. His initial oxygen saturation registered at SpO2 (blood oxygenation saturation) 55% on room air. Emergency physicians employed a novel non-invasive oxygenation strategy using a nasal cannula, non-rebreather, and self-proning. This approach led to a reversal of the patient’s respiratroy distress and hypoxia (SpO2 88-95%) for the following 24 hours.This non-invasive intervention allowed providers time to obtain and initiate high-flow nasal cannula and discuss end-of-life wishes with the patient and his family.
Conclusion: Our case highlights a stepwise, organized approach to providing non-invasive oxygenation for COVID-19 patients presenting with severe hypoxia and acute respiratory distress. This approach primarily employs resources and equipment that are readily available to healthcare providers around the world. The intent of this strategy is to provide conventional alternatives to aid in the initial airway management of confirmed or suspected COVID-19 patients.
Introduction: The novel coronavirus disease 2019 (COVID-19) presents a challenge for healthcare providers in terms of diagnosis, management, and triage of cases requiring admission.
Case Report: A 47-year-old male with symptoms suspicious for COVID-19, pulse oximetry of 93% on room air, and multifocal pneumonia was risk stratified and safely discharged from the emergency department (ED) despite having moderate risk of progression to acute respiratory distress syndrome. He had resolution of his symptoms verified by telephone follow-up.
Conclusion: Various risk-stratifying tools and techniques can aid clinicians in identifying COVID-19 patients who can be safely discharged from the ED.
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