Two <scp>H</scp>our <scp>E</scp>valuation and <scp>R</scp>eferral <scp>M</scp>odel for <scp>S</scp>horter <scp>T</scp>urnaround <scp>T</scp>imes in the emergency department

Burke, John; Greenslade, Jaimi; Chabrowska, Jadwiga; Greenslade, Katherine; Jones, Sally; Montana, Jacqueline; Bell, Anthony; O’Connor, Allan

doi:10.1111/1742-6723.12781

Cited by 20 publications

(35 citation statements)

References 25 publications

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“…The excellent article by Burke et al . demonstrates how a well planned and executed process redesign can work . It was encouraging to see some effect across whole‐of‐hospital processes, with reductions in time in all phases of the patient journey.…”

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confidence: 85%

“…Burke et al allude to the difficulties in measuring these potential issues. 1 The broader philosophical question raised by this study is whether we should need jurisdictional targets at all to drive improvements in patient care. The redesign underlying THER-MoSTAT was fairly basicget senior decision-making up front and minimise any unnecessary steps in the patient journey.…”

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confidence: 98%

“…The excellent article by Burke et al demonstrates how a well planned and executed process redesign can work. 1 It was encouraging to see some effect across whole-of-hospital processes, with reductions in time in all phases of the patient journey. However, the reported times still leave ample room for improvement mainly by reducing medical handover and bed delay times that remained long, even after THERMo-STAT.…”

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confidence: 98%

“…The broader philosophical question raised by this study is whether we should need jurisdictional targets at all to drive improvements in patient care. The redesign underlying THERMoSTAT was fairly basic – get senior decision‐making up front and minimise any unnecessary steps in the patient journey . Over the years there have been many variations on this theme, with variable success.…”

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confidence: 99%

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The National Emergency Access Target performance and all that!!

Cameron

Mitra

Smit

2017

Emerg Medicine Australasia

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confidence: 85%

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confidence: 98%

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confidence: 98%

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confidence: 99%

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The National Emergency Access Target performance and all that!!

Cameron

Mitra

Smit

2017

Emerg Medicine Australasia

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“…The study site was a large, metropolitan, level‐six, tertiary referral adult ED in Queensland, Australia with an annual census of over 78 000 (2017). The ED uses an innovative model of care, which combines clinical streaming and team‐based assessment . Patient care is provided 24/7 by a large, multi‐disciplinary team consisting of medical, nursing, psychiatric, social work, radiology and pathology services.…”

Section: Methodsmentioning

confidence: 99%

Security interventions are frequently undocumented in emergency department clinical notes

Duncan

Brown

Hughes

et al. 2019

Emerg Medicine Australasia

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Objective To compare the documentation of security interventions in ED presentations between clinical notes and security records. Methods Presentations (n = 680) were randomly selected from all ED presentations to a public tertiary referral hospital in Queensland, Australia between April 2016 and August 2017 that were perceived by the treating clinician as alcohol‐related. Retrospective data, manually extracted from clinical notes and the security service database, were compared for the documentation of any security interventions. Security interventions were defined as observation without physical contact, verbal de‐escalation or physical restraint by security officers. Results Forty‐one presentations had security interventions documented in the security services database and, of those, 20 (48.8%) had documentation in the clinical notes. Patients who required security interventions were admitted to hospital in higher proportions compared with those who did not (73.2% vs 26.8%, respectively, P < 0.0001). Conclusion The rate of documentation of security interventions in clinical notes was less than 50%. Documentation of critical information, including alerts and risks, in the clinical notes is an essential component of communication that the multi‐disciplinary team use to ensure patient safety. Strategies aimed at improving the documentation of security interventions in clinical notes will help to optimise risk management and the safety of patients, staff and visitors along the continuum of care.

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Cost and Visit Duration of Same-Day Access at an Academic Ophthalmology Department vs Emergency Department

Singman

Smith²,

Mehta

et al. 2019

JAMA Ophthalmol

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IMPORTANCE Convenient outpatient access for ophthalmology patients seeking urgent care could offer savings compared with an emergency department (ED) visit. OBJECTIVE To evaluate the costs and visit durations of same-day access (SDA) in an ophthalmology department at an academic medical center vs ED care. DESIGN, SETTING, AND PARTICIPANTS This single-center study was a retrospective quality improvement analysis of an institutional electronic medical record system at the Wilmer Eye Institute clinics and the Johns Hopkins Hospital ED. On June 1, 2015, the Wilmer Eye Institute and Johns Hopkins Hospital initiated an official policy of providing SDA to patients calling for appointments (ie, the same-day project). All ophthalmology clinic locations created same-day appointment slots for at least 1 practitioner. In recognition of seasonal variations in patient visit volumes, the 10 months before implementation (August 1, 2014, to May 31, 2015) were compared with complementary periods in 2015 to 2016 and 2016 to 2017. MAIN OUTCOMES AND MEASURES The study tabulated encounters, charges, and visit length for outpatients seen on the same day or by previously scheduled appointments. For the ED patients, volume, diagnoses, charges, and length of stay data were collected. The numbers of SDA patients who indicated urgency were tabulated.

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Two Hour Evaluation and Referral Model for Shorter Turnaround Times in the emergency department

Abstract: A facilitated team leader role for senior doctors can help to reduce length of stay by via early disposition, without significant risks to the patient.

Cited by 20 publications

References 25 publications

The National Emergency Access Target performance and all that!!

The National Emergency Access Target performance and all that!!

Security interventions are frequently undocumented in emergency department clinical notes

Cost and Visit Duration of Same-Day Access at an Academic Ophthalmology Department vs Emergency Department

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