Emergency Department Overcrowding

Schull, Michael J.; Cooke, Matthew

doi:10.1002/9781444303674.ch8

Cited by 2 publications

(7 citation statements)

References 75 publications

(77 reference statements)

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“…Although benefits in efficiency 16 and outcomes are proven, [17][18][19][20] care must still be taken to ensure that significant comorbidities are addressed, and while an emphasis on fast patient moving is beneficial, an awareness of the often significant comorbidities associated with this population is necessary. A report by Ollivere et al has highlighted the significant concurrent medical problems that may be inadequately addressed including concerns over suboptimal hydration in this population, leading to a suggestion that greater attention is paid to physiological parameters and ''early warning systems'' to be incorporated into fast track pathways.…”

Section: Introductionmentioning

confidence: 99%

“Tiers of Delay”

Eardley

MacLeod

Freeman

et al. 2014

Geriatr Orthop Surg Rehabil

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Anticoagulation reversal is a common cause of operative delay. We sought to establish for the first time the impact this has on best practice tariff (BPT) for patients with hip fracture admitted on warfarin. All patients with hip fracture treated operatively over a 32-month period were reviewed. Basic demographics, time to theater, length of stay, and mortality were recorded for all patients. Independent samples t-tests were used to identify statistically significant differences between patients on warfarin and those not taking the drug. A total of 83 patients were admitted anticoagulated with a mean international normalized ratio of 2.65 and a median time to theater of 49.7 hours. Of these patients, 79% breached BPT, incurring significant financial loss. In the control group, 908 patients took a median 24.5 hours, a 28% breach of BPT (P < .01). Length of stay, Nottingham Hip Fracture Score, and predicted 30-day mortality were similar for both the groups. As well as affecting clinical outcome following hip fracture, delay due to anticoagulation causes considerable loss of BPT. Potential loss of revenue due to delays over the study period was £80 000, inspiring the establishment of an ''early trigger'' anticoagulation protocol. Although it is accepted that there are limitations to this work, it should raise awareness of the real impact of warfarin on patients with hip fracture both in terms of outcome and for the first time, loss of potential revenue.

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Section: Introductionmentioning

confidence: 99%

“Tiers of Delay”

Eardley

MacLeod

Freeman

et al. 2014

Geriatr Orthop Surg Rehabil

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“…Failing to diagnose the emergency triage nurse correctly and repeating the patient's referrals 28,36 …”

Section: Resultsmentioning

confidence: 99%

“…Failure to correctly diagnose the doctor, repeating tests and procedures as a result of increasing the patient's waiting time 28,31 …”

Section: Resultsmentioning

confidence: 99%

“…A science‐based assessment of the root causes of problems and their effects is needed to meet the needs of the ED. Additionally, a science‐based assessment of patients that have been presented as a basis for formulating future strategic directions and policies, and processes and improving the quality of services in the ED 13,28 …”

Section: Discussionmentioning

confidence: 99%

“…In this analysis, evaluating programs, sub‐policies, and strategies are based on the participation of all members related to the ED 21 . Evaluating the strengths and weaknesses of the various elements of the ED and implementation plans is not only done by technical experts and specialists but also by health service providers, representatives of patients, and stakeholders 21,28 . In other words, emergency strategies and plans should not be based only on the experts' opinions but also on the patient's perceptions, opinions, preferences, and expectations so that they can help formulate long‐term strategies 47 .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Situation analysis model of hospital emergency department promotion in Iran: A cross‐sectional study

Asadi,

Anvari,

Ramezanghorbani

et al. 2023

Health Science Reports

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Background and AimThe present study was conducted to develop a situation analysis model for Iran's hospitals' emergency departments (EDs).MethodsThe current research was a descriptive cross‐sectional applied study in three stages. The studies were reviewed in various library resources and valid sites in the first stage. In the second stage, the analysis model of the ED in Iran was presented. In the third stage, the model was validated based on the Delphi technique, and the final model was presented.ResultsThe final situation analysis model of ED in Iran was approved in four main aspects, including goals, internal factors, external factors, and organizations and institutions participating in the situation analysis, and its implementation schedule was approved by 90% of experts.ConclusionConsidering the importance of situation analysis in developing a strategic plan and improving the quality of health services in the ED of hospitals, implementing a coherent situation analysis model that includes all aspects leading to improving the ED quality and analyzing the internal and external factors is vital.

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Emergency Department Overcrowding

Cited by 2 publications

References 75 publications

“Tiers of Delay”

“Tiers of Delay”

Situation analysis model of hospital emergency department promotion in Iran: A cross‐sectional study

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