Annals of family medicine
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Annals of family medicine · Nov 2024
Randomized Controlled TrialEffectiveness of Collaborative, Trauma-Informed Care on Depression Outcomes in Primary Care: A Cluster Randomized Control Trial in Chile.
The purpose of this study was to evaluate the effectiveness of collaborative trauma-informed care (CTIC) for treating depression in primary care in Chile. ⋯ The CTIC approach demonstrated superior outcomes in treating depression and improving adherence compared with UT. Moreover, the observed trends in anxiety improvement warrant further exploration in future research with a larger sample size. It is necessary to assess the effectiveness of this approach in treating more complex, difficult-to-treat forms of depression.
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Annals of family medicine · Nov 2024
Beyond Education: What is required to support staff to promote equity-oriented health care in EDs?
Context: Staff in Canadian Emergency Departments (EDs) face increasing workplace demands arising in part from system-wide shortages in primary and community care. Patients experiencing stigmatizing conditions such as chronic pain, substance use, and psychiatric disorders may turn to the ED as the only open "door" to access care in the community. Objective: To examine staff perceptions about their work and role, including how they may be prepared or not to address issues of health and health care inequities in EDs. ⋯ Conclusions: The impacts of shortages in primary care reverberate throughout the system. EDs often prioritize efficiency, a focus which cannot adequately equip staff to promote equity. Attention and commitment to addressing structural inequities within EDs could support patients and staff to move closer to the quintuple aim.
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Annals of family medicine · Nov 2024
Development of an Emergency Department Surge Plan Based on the NEDOCS score.
Context: Emergency Department (ED) overcrowding is a significant problem worldwide. Many factors contribute to ED overcrowding, including staffing shortages, diagnostic testing delays, and inadequate inpatient beds to meet the demand. ED overcrowding results in patient safety issues like higher inpatient mortality and other negative impacts, such as an increased length of stay (LOS) and an increased trend of leaving the ED before undergoing an evaluation and treatment. ⋯ Conclusions: Our study suggests that implementing an ED adult surge plan can significantly improve ED hold hours and NEDOCS scores. However, it is important to note that other important ED throughput metrics (mean ED LOS, left without seen rate, mean door-to-doctor exam time) did not significantly improve. Further research may be necessary to understand the factors contributing to these outcomes and identify additional interventions that may improve ED throughput.