Converting an ED Fast Track to an ED Virtual Visit Track

Ashenburg, Nicholas; Ribeira, Ryan; Lindquist, Benjamin; Matheson, Loretta; Shen, Sam; Yiadom, Maame Yaa A. B.

doi:10.1056/cat.22.0130

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Overall, the outcomes of most interventions within the Technology/Innovation category were mixed or nonsignificant. Based on available evidence, various technologies, such as nurse call lines, on-demand telehealth visits, tele-triage, and paramedic-driven mobile response programs, were identified as valuable tools for screening patients before their arrival at the emergency department, aiming to mitigate ED overcrowding [ 91 , 92 ]. Additionally, telemedicine tools such as remote patient monitoring and virtual visits have been employed in home hospital settings, while virtual observation units facilitate early discharge from hospitals or emergency departments, enabling patients to transition to home care [ 79 , 93 , 94 ].…”

Section: Discussionmentioning

confidence: 99%

Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system

Samadbeik,

Staib,

Boyle

et al. 2024

BMC Health Serv Res

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Background Globally, emergency departments (EDs) are overcrowded and unable to meet an ever-increasing demand for care. The aim of this study is to comprehensively review and synthesise literature on potential solutions and challenges throughout the entire health system, focusing on ED patient flow. Methods An umbrella review was conducted to comprehensively summarise and synthesise the available evidence from multiple research syntheses. A comprehensive search strategy was employed in four databases alongside government or organisational websites in March 2023. Gray literature and reports were also searched. Quality was assessed using the JBI critical appraisal checklist for systematic reviews and research syntheses. We summarised and classified findings using qualitative synthesis, the Population-Capacity-Process (PCP) model, and the input/throughput/output (I/T/O) model of ED patient flow and synthesised intervention outcomes based on the Quadruple Aim framework. Results The search strategy yielded 1263 articles, of which 39 were included in the umbrella review. Patient flow interventions were categorised into human factors, management-organisation interventions, and infrastructure and mapped to the relevant component of the patient journey from pre-ED to post-ED interventions. Most interventions had mixed or quadruple nonsignificant outcomes. The majority of interventions for enhancing ED patient flow were primarily related to the 'within-ED' phase of the patient journey. Fewer interventions were identified for the 'post-ED' phase (acute inpatient transfer, subacute inpatient transfer, hospital at home, discharge home, or residential care) and the 'pre-ED' phase. The intervention outcomes were aligned with the aim (QAIM), which aims to improve patient care experience, enhance population health, optimise efficiency, and enhance staff satisfaction. Conclusions This study found that there was a wide range of interventions used to address patient flow, but the effectiveness of these interventions varied, and most interventions were focused on the ED. Interventions for the remainder of the patient journey were largely neglected. The metrics reported were mainly focused on efficiency measures rather than addressing all quadrants of the quadruple aim. Further research is needed to investigate and enhance the effectiveness of interventions outside the ED in improving ED patient flow. It is essential to develop interventions that relate to all three phases of patient flow: pre-ED, within-ED, and post-ED.

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Section: Discussionmentioning

confidence: 99%

Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system

Samadbeik,

Staib,

Boyle

et al. 2024

BMC Health Serv Res

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Leveraging Telemedicine to Reduce ED Overcrowding: The Quirónsalud Virtual Urgent Care Program

Short Apellaniz,

Álvaro de la Parra,

Gomez-Meana

et al. 2023

NEJM Catalyst

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Strategies to mitigate emergency department crowding and its impact on cardiovascular patients

Baugh

Freund

Steg

et al. 2023

European Heart Journal: Acute Cardiovascular Care

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Emergency Department (ED) crowding is a worsening global problem caused by hospital capacity and other health system challenges. While patients across a broad spectrum of illnesses may be affected by crowding in the ED, patients with cardiovascular emergencies - such as acute coronary syndrome, malignant arrhythmias, pulmonary embolism, acute aortic syndrome, and cardiac tamponade - are particularly vulnerable. Because of crowding, patients with dangerous and time-sensitive conditions may either avoid the ED due to anticipation of extended waits, leave before their treatment is completed, or experience delays in receiving care. In this educational paper, we present the underlying causes of crowding and its impact on common cardiovascular emergencies using the input-throughput-output process framework for patient flow. In addition, we review current solutions and potential innovations to mitigate the negative effect of ED crowding on patient outcomes.

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Converting an ED Fast Track to an ED Virtual Visit Track

Cited by 3 publications

References 22 publications

Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system

Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system

Leveraging Telemedicine to Reduce ED Overcrowding: The Quirónsalud Virtual Urgent Care Program

Strategies to mitigate emergency department crowding and its impact on cardiovascular patients

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