Articles: hospital-emergency-service.
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Randomized Controlled Trial
Patient readmissions, emergency visits, and adverse events after software-assisted discharge from hospital: cluster randomized trial.
One of the causes of postdischarge adverse events is poor discharge communication between hospital-based physicians, patients, and outpatient physicians. The value of hospital discharge software to improve communication and clinically relevant outcomes is unknown. ⋯ Discharge software with CPOE did not affect readmissions, emergency department visits, or adverse events after discharge. Future studies should assess other endpoints such as patient perceptions or physician perceptions to see if discharge software has value.
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Randomized Controlled Trial
Computerized decision support to reduce potentially inappropriate prescribing to older emergency department patients: a randomized, controlled trial.
To evaluate the effectiveness of computer-assisted decision support in reducing potentially inappropriate prescribing to older adults. ⋯ Computerized physician order entry with decision support significantly reduced prescribing of potentially inappropriate medications for seniors. This approach might be used in other efforts to improve ED care.
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Randomized Controlled Trial Comparative Study
Home oxygen for children with acute bronchiolitis.
A prospective randomised controlled pilot study was performed comparing home oxygen therapy with traditional inpatient hospitalisation for children with acute bronchiolitis. Children aged 3-24 months with acute bronchiolitis, still requiring oxygen supplementation 24 h after admission to hospital, were randomly assigned to receive oxygen supplementation at home with support from "hospital in the home" (HiTH) or to continue oxygen supplementation in hospital. 44 children (26 male, mean age 9.2 months) were recruited (HiTH n = 22) between 1 August and 30 November 2007. ⋯ Children in the HiTH group spent almost 2 days less in a hospital bed than those managed as traditional inpatients: HiTH 55.2 h (interquartile range (IQR) 40.3-88.9) versus in hospital 96.9 h (IQR 71.2-147.2) p = 0.001. Home oxygen therapy appears to be a feasible alternative to traditional hospital oxygen therapy in selected children with acute bronchiolitis.
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Randomized Controlled Trial
Randomized trial of computerized quantitative pretest probability in low-risk chest pain patients: effect on safety and resource use.
We hypothesize that the presentation of a quantitative pretest probability of acute coronary syndrome would safely reduce unnecessary resource use in low-risk emergency department (ED) chest pain patients. ⋯ Presentation of a quantitative estimate of the pretest probability of acute coronary syndrome to clinicians and low-risk ED chest pain patients was associated with reduced resource use, without evidence of increased rate of premature discharge of patients with acute coronary syndrome.
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Arch Pediatr Adolesc Med · Jun 2009
Randomized Controlled TrialEffect of telephone calls from primary care practices on follow-up visits after pediatric emergency department visits: evidence from the Pediatric Emergency Department Links to Primary Care (PEDLPC) randomized controlled trial.
To test whether follow-up phone calls to counsel families about pediatric emergency department (PED) use and primary care availability made after an index PED visit would modify subsequent PED use. ⋯ Follow-up phone calls from primary care practices after PED visits counseling patients on the use of primary care and emergency services can modulate subsequent care-seeking behavior and decrease future PED use.