Articles: emergency-services.
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Multicenter Study
Predictors and outcomes of frequent emergency department users.
To identify predictors and outcomes associated with frequent emergency department (ED) users. ⋯ Frequent ED visits are associated with socioeconomic distress, chronic illness, and high use of other health resources. Efforts to reduce ED visits require addressing the unique needs of these patients in the emergency and primary care settings.
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Multicenter Study
Establishing a bereavement program: caring for bereaved families and staff in the emergency department.
The successful planning and implementation of a Bereavement Program in the Emergency Departments of two of Melbourne's major metropolitan teaching hospitals, Monash Medical Centre (MMC) and Dandenong Hospital (DH) was in response to staff dissatisfaction regarding their capacity to care for bereaved families and involved staff. Key influencing factors were identified and literature evidence was sought. ⋯ Fundamental to facilitating these improvements was the need for staff education in the needs of families, self and staff and a grief education program was arranged, and provided through multiple sources, utilising the expertise of the Centre for Grief Education. The extremely positive feedback, which has been received from families and ED staff is testimony to the care delivered and the difference the Program is making at Southern Health, to those experiencing a death in the Emergency Department.
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Multicenter Study
A brief risk-stratification tool to predict repeat emergency department visits and hospitalizations in older patients discharged from the emergency department.
To evaluate the predictive ability of a simple six-item triage risk screening tool (TRST) to identify elder emergency department (ED) patients at risk for ED revisits, hospitalization, or nursing home (NH) placement within 30 and 120 days following ED discharge. ⋯ Older ED patients with two or more risk factors on a simple triage screening tool were found to be at significantly increased risk for subsequent ED use, hospitalization, and nursing home admission.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Rapid two-stage emergency department intervention for seniors: impact on continuity of care.
A two-stage intervention comprising screening and a brief standardized nursing assessment and referral, for emergency department (ED) patients aged 65 years and over, reduced the rate of functional decline four months after the visit, without increasing societal costs. In this study, the authors investigated the effects of the intervention on the process of care at, and during the month after, the ED visit. ⋯ The beneficial outcomes of the intervention appear to result primarily from the early provision of home care rather than early contact with the primary physician.
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Multicenter Study Comparative Study
Use of out of hours services: a comparison between two organisations.
To investigate differences in numbers and characteristics of patients using primary or emergency care because of differences in organisation of out of hours care. ⋯ The organisation of out of hours care in Maastricht has optimised the GP's gatekeeper function and thereby led to fewer self referrals at the A&E department, compared with Heerlen.