Articles: emergency-services.
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Int J Qual Health Care · Aug 1999
Multicenter StudyQuality management in Australian emergency medicine: translation of theory into practice.
The primary objective was to describe the current level of implementation of quality management (QM) structures and practices with Australian emergency departments. The secondary objective was to describe the level of association between the presence of QM structures and processes and the achievement of associated improvements. ⋯ Demonstration of the links between QM structures, its indicators of activity (in structure and process), and the achievement of outcome improvement is fundamental to quality improvement methodology. These links are demonstrated within the context of Australian emergency medicine, providing support for the effectiveness of this approach in promoting change and performance improvement.
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Multicenter Study
Emergency department impact of the Oklahoma City terrorist bombing.
To collect descriptive epidemiologic injury data on patients who suffered acute injuries after the April 19, 1995, Oklahoma City bombing and to describe the effect on metropolitan emergency departments. ⋯ EMS providers tended to transport the more seriously injured patients, who tended to arrive in a second wave at EDs. The closest hospitals received the greatest number of victims by all transport methods. The effects on pharmaceutical use and ancillary service were consistent with the care of penetrating and blunt trauma. The diagnoses in the ED support previous reports of the complex but often nonlethal nature of bombing injuries.
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Health Care Manag Sci · Jul 1999
Randomized Controlled Trial Multicenter Study Clinical TrialThe quick response initiative in the emergency department: who benefits?
This collaborative project between two community hospitals, a Metropolitan Home Care Program and the University, was designed to quantify the applicability (who is eligible for) and acceptability (who will likely comply with) Home Care services, provided through a Quick Response Program (QRP) initiative as compared to usual hospital care services, to patients, families and physicians. ⋯ The QRP Initiative was applicable to 2% of the total ED patient population and 5% of the urgent category of patients triaged in the ED. It was acceptable to 97% of this eligible group. One hundred and fifty-five patients who initially qualified for QRP were excluded from eligibility at a subsequent assessment. Ninety of these patients were admitted to hospital and 65 were discharged home. In the total "exclusion" group, 37 refused Home Care services including the QRP. HEALTH CARE PRACTICE IMPLICATIONS: The sampling results raise important questions about broader system issues concerning the role of the hospital and community in providing health care services and the social value or utility that guides the allocation of health care funds. What level of applicability and acceptability would justify priority services for certain target groups. In the future, policy makers will need to be able to show that it is in the best interest of patients and society to prioritize mixtures of services to certain target groups.
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Multicenter Study
Sex differences among adults presenting to the emergency department with acute asthma. Multicenter Asthma Research Collaboration Investigators.
Asthma is an increasing problem worldwide, particularly among women. Sex differences in acute asthma presentation, management, or outcome would have important medical and economic implications. ⋯ Of adults who presented to the ED with acute asthma, women were almost twice as common as men. Although men received less outpatient care and had worse pulmonary function, women were more likely to be admitted to the hospital and to report an ongoing exacerbation at follow-up. Further studies are needed to better understand the complex relationship between sex and acute asthma.
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Multicenter Study
Primary care physician and patient factors that result in patients seeking emergency care in a hospital setting: the patient's perspective.
Much has been written about "abuse" and "overutilization" of Emergency Departments (EDs). We undertook to study, from the patient's perspective, physician and patient factors that influence the patient's decision to seek ED care. The study was designed as a convenience cohort, multi-centre survey, conducted in 13 hospitals in the Greater Toronto Area. ⋯ As many as 55% of patients presented to the ED because it was more convenient. Only a minority (23%) of patients felt their acuity of illness warranted an ED visit. Primary care physicians need to play a stronger role in educating their patients about the utilization of emergency care and the services offered in the office setting.