CJEM
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While quality improvement (QI) and clinical research embody two distinct scientific approaches, they have the same ultimate goal-to improve health and patient care outcomes. By leveraging their respective strengths there is a higher likelihood of achieving and sustaining health improvements. Our objective was to create recommendations to enhance the collaboration of the Canadian emergency medicine QI and clinical research communities. ⋯ Six recommendations are presented to help the Canadian emergency medicine community achieve greater collaboration between researchers and QI experts with the ultimate goal of improving patient care outcomes.
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Randomized Controlled Trial
Self-assessment of functional status in older emergency department patients: a cross-over randomized pilot trial.
To assess the inter-rater reliability and feasibility of the self-assessed Older Americans Resources and Services scale compared to its administration by a research assistant in older Emergency Department (ED) patients. ⋯ Our results indicate that self-assessment of functional status by older ED patients is feasible, and good-to-moderate inter-rater reliability results were obtained. A self-assessed score may identify patients in need of further geriatric/functional assessment who may otherwise have been left unscreened.
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We implemented a novel transition-to-practice curriculum incorporating four new processes to prepare CCFP(EM) residents for independent practice. These elements were: 1) explicit sequencing of competency progression; 2) establishment of coaching teams; 3) establishment of independent shifts; and 4) implementation of a transition-to-practice seminar series. ⋯ All residents rated competency progression, coaching teams, independent shifts and transition-to-practice series favourably. This framework can be used by other 1-year enhanced skills or other fellowship programs to prepare their residents for independent practice.
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Atrial fibrillation increases the risk of stroke, which can be mitigated by anticoagulant prescription. We evaluated local emergency physician anticoagulation practice for patients discharged from the emergency department with atrial fibrillation, along with 90-day incidence of stroke and major bleeding. ⋯ Few eligible patients were prescribed anticoagulation and the 90-day stroke rate was high. Physicians should become familiar with the CAEP Acute AF Best Practices Checklist AF which offers guidance on anticoagulation prescription.