Annals of emergency medicine
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We sought to test the effectiveness of an intervention designed to replace multivitamin infusions with alternative vitamin therapies when treating emergency department (ED) patients who present with alcohol-related illnesses. Most patients presenting to the ED with alcohol-related illnesses are not vitamin deficient, and thus the routine use of multivitamin infusions may be unnecessary. ⋯ Our educational and order entry intervention was effective in changing physician vitamin prescribing behavior in ED patients with an alcohol-related illness.
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To address concerns about prolonged emergency department (ED) stays from crowding, England mandated that the maximum length of ED stay for 98% of patients be no greater than 4 hours. We evaluate the effect of the mandated ED care intervals in England. ⋯ The introduction of a time target reduced the proportion of patients staying greater than 4 hours. More patients departed within 20 minutes of the target 4-hour interval after the mandate, notably, the elderly.
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Nontechnical skills are "the cognitive, social and personal resource skills that complement technical skills, and contribute to safe and efficient task performance." Our research team developed and evaluated the task of developing and validating a behavioral marker system for the observational assessment of emergency physicians' nontechnical skills. ⋯ Although further evaluative studies are needed, this behavioral marker system provides a structured approach to the assessment and training of nontechnical skills in the ED.