Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Review
Crowding Measures Associated With the Quality of Emergency Department Care: A Systematic Review.
Despite the substantial body of literature on emergency department (ED) crowding, to the best of our knowledge, there is no agreement on the measure or measures that should be used to quantify crowding. The objective of this systematic review was to identify existing measures of ED crowding that have been linked to quality of care as defined by the Institute of Medicine (IOM) quality domains (safe, effective, patient-centered, efficient, timely, and equitable). ⋯ The results of this review provide data on the association between ED crowding measures and quality of care. Three simple crowding measures have been linked to quality of care in multiple publications.
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This study explored what smartphone health applications (apps) are used by patients, how they learn about health apps, and how information about health apps is shared. ⋯ While mobile health has experienced tremendous growth over the past few years, use of health apps among our sample was low. The most commonly used apps were those that had broad functionality, while the most frequently used health apps encompassed the topics of exercise, diet, and brain teasers. While participants most often shared information about health apps within their social networks, information was less frequently shared with providers, and physician recommendation played a small role in influencing patient use of health apps.
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Multicenter Study Comparative Study Observational Study
Measurement and Monitoring of Nausea Severity in Emergency Department Patients: A Comparison of Scales and Exploration of Treatment Efficacy Outcome Measures.
The objective was to investigate the correlation of the visual analog scale (VAS) and numeric rating scale (NRS) for nausea severity measurement and to explore options for improved reporting of antiemetic efficacy trial results. ⋯ The VAS and NRS correlate highly. A VAS cutoff level of ≥-5 mm was a good predictor of symptom improvement, suggesting that its inclusion as an outcome measure would enhance reporting in antiemetic efficacy trials.
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The Joint Commission Comprehensive Stroke Center certification requires that magnetic resonance imaging (MRI) be available on site, 24 hours a day, 7 days a week for evaluation of stroke in emergency department (ED) patients. Increased access to advanced diagnostic imaging has been shown to increase utilization, ED length of stay (LOS), and health care costs. EDs nationwide face decisions to pursue certification and increase MRI access. Understanding changes in utilization and the downstream effects may inform these decisions. ⋯ Emergency MRI utilization increased substantially after placement of a fully accessible MRI in the ED. Patients receiving emergency MRI had increased ED LOS, decreased admission rates for some patients (rule-out stroke), and reduced hospital LOS for those admitted. Potential changes in ED patient resource utilization should be considered when determining whether to acquire an MRI for Comprehensive Stroke Center certification.