The American journal of emergency medicine
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The increasing complexity of ED physician performance measures has resulted in significant challenges, including duplicative and conflicting measures that fail to account for different ED settings. We performed a cross sectional analysis of correlations between measures to characterize their relationships and determine if differences exist between academic versus non-academic ED settings. Pearson correlations were calculated for 12 measures among 220 ED physicians at 11 EDs. ⋯ Stronger measure correlations were found in the academic setting compared to the non-academic setting. Strong correlations between ED measures imply opportunities to reduce competing performance demands on clinicians. Differences in correlations at academic versus non-academic settings suggest that it may be inappropriate to apply the same performance standards across settings.
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This study evaluates the time to attempted patient contact for positive blood cultures in patients discharged from the Emergency Department (ED) resulting when an Emergency Medicine (EM) pharmacist is on-duty compared to off-duty. ⋯ In patients discharged from the ED with subsequent positive blood cultures, time to attempted patient contact was significantly shorter when a pharmacist was on-duty. Our data emphasizes the importance of having a standardized practice in place to optimize ED patient care and outcomes and the benefit of a pharmacist's involvement in the process.
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This study compares the results of Artificial Intelligence (AI) diagnosis of rib fractures using initial CT and follow-up CT as the final diagnostic criteria, and studies AI-assisted diagnosis in improving the detection rate of rib fractures. ⋯ AI-assisted diagnosis improved the detection rate of rib fractures, the follow-up CT should be used for the diagnosis standard of rib fractures, and AI misdiagnoses can be greatly reduced when a radiologist reviews the diagnosis.
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Hypotension in the emergency department (ED) is known to be associated with increased mortality, however, the relationship between timing of hypotension and mortality has not been investigated. The objective of the study was to compare the mortality rate of patients presenting with hypotension with those who develop hypotension while in the ED. ⋯ This study demonstrated hypotension in the ED was associated with a very significantly increased risk of in-hospital mortality. However, there was no significant increase in mortality between those patients with hypotension on arrival those who develop hypotension while in the ED. These finding underscore the importance of careful hemodynamic monitoring for patients in the ED throughout their stay.
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The role of the Emergency Department (ED) as a vital constituent in Hepatitis C (HCV) screening has become increasingly evident. A key component of the ED's role in HCV screening is the ability to effectively link HCV-RNA positive patients to definitive, HCV-specific care, to include direct-acting antiviral (DAA) medication with resultant sustained virologic response (SVR). We sought to consider the rate of HCV-specific linkage, DAA initiation, and SVR obtained in HCV patients identified from an ED screening program. ⋯ An ED-based HCV screening program can result in successful HCV-specific linkage and care, to include DAA initiation and ultimately, SVR. Among linked patients, specific cohort considerations may demonstrate differences in age and insurance status which may have implications on DAA application and adherence, and therefore, individual ability to achieve SVR.