Articles: emergency-services.
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Multicenter Study Observational Study
Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act.
There is a continued movement toward health data transparency, accelerated by the 21st Century CURES Act, which mandated the automatic and immediate release of clinical notes, often termed "open notes." Differences in utilization among different patient demographics and disproportionately affected populations within the emergency department (ED) are not yet known. ⋯ We identified substantial differences in digital access to clinical notes as well as patient utilization of open notes in a large, diverse sample. Health transparency initiatives must address not only technology adoption broadly but also the unique barriers faced by populations experiencing disadvantage to facilitate equitable access to and awareness about digital health tools without the unintended consequence of expanding disparities.
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Case Reports Multicenter Study
Validated scoring system identifies low-risk syncope patients.
This study validated the Canadian Syncope Risk Score for predicting 30-day serious outcomes in patients presenting to the ED within 24 hours of syncope.
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Multicenter Study
Flattening the other curve: Reducing emergency department STEMI delays during the COVID-19 pandemic.
The COVID-19 pandemic has been associated with ST-Elevation Myocardial Infarction (STEMI) reperfusion delays despite reduced emergency department (ED) volumes. However, little is known about ED contributions to these delays. We sought to measure STEMI delays and ED quality benchmarks over the course of the first two waves of the pandemic. ⋯ Both DTE and ETA metrics worsened during the first wave of the pandemic, revealing how it negatively impacted the triage and diagnosis of STEMI patients. But these normalized after the first wave and were unaffected by the second wave, indicating that nurses and physicians adapted to the pandemic to maintain STEMI quality of care. DTE and ETA metrics can help EDs identify delays to reperfusion during the pandemic and beyond.
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Older adults presenting to the emergency department (ED) are at high risk of adverse health outcomes. This study aimed to evaluate the accuracy of 4 frequently used screening instruments for the prediction of adverse health outcomes among older adults in the ED. ⋯ The frailty screening instruments assessed in this study showed poor to moderate prognostic accuracy, which brings into question their usability in the prediction of adverse health outcomes among older adults who present to the ED.
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Multicenter Study
SECUre: a multicentre survey of the safety of emergency care in UK emergency departments.
According to safety theory, frontline staff are often best informed to identify problems that threaten safety in their workplace. Surveying emergency department (ED) staff is a straightforward method for investigating risks, identifying solutions and evaluating interventions. This study's aim was to validate an ED safety questionnaire specifically for use in the UK and provide an overview of safety culture and risks. ⋯ This study provides the first step towards assessing ED safety culture and describing risks in the UK. Identifying outlier sites provides opportunities to learn from excellence. Repeat application of the survey will enable monitoring of safety interventions on a local and national level.