Articles: emergency-services.
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Bull Am Acad Psychiatry Law · Jan 1995
Differential use of admission status in a psychiatric emergency room.
The goal of this study is to understand how different admission statuses of varying degrees of restrictiveness (informal, voluntary, emergency admission, and involuntary admission on medical certification) are used in the psychiatric emergency room. The study included 656 consecutively admitted patients from a psychiatric emergency room over 28 months. Data were analyzed univariately and using two discriminant function models. ⋯ Emergency admission patients (21%, n = 138) were characterized by being between 40 to 50 years old, having a diagnosis of psychoactive substance abuse, having previous outpatient treatment, and having been referred by emergency service. The major difference between involuntary admissions and voluntary was that the former were more often actively psychotic or referred by police or court. The major difference between emergency admission and involuntary admission on medical certification seemed to be that patients with a more available support system, whose primary diagnoses was not substance abuse and who were suicidal, were preferred for involuntary admission on medical certification.
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Death can often be distressing but when it occurs in the Accident and Emergency (A & E) department it is often accompanied by the involvement of police and the coroner. It is essential that nurses have a sound understanding of the legal situation, so that they can advise relatives appropriately and so that they know clearly the appropriate practice and procedures to prevent further difficulties. This article seeks to set down some of the basic principles and looks at some situations which can cause anxiety to nursing staff.
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Healthc Manage Forum · Jan 1995
Development, testing and implementation of an emergency services methodology in Alberta.
Alberta was the first province in Canada to mandate reporting of hospital-based emergency services. This reporting is based on a workload measurement system that groups emergency visits into five discreet workload levels/classes driven by ICD-9-CM diagnoses. Other related workload measurement variables are incorporated, including admissions, transfers, maintenance monitoring, nursing and non-nursing patient support activities, trips, staff replacement, and personal fatigue and delay. ⋯ This would be the first time that such services would be funded on a systemic, system-wide basis whereby hospitals would be reimbursed in relation to workload. This proposed funding system would distribute available funding in a consistent, fair and equitable manner across all hospitals providing a similar set of services, thus achieving one of the key goals of the Alberta Acute Care Funding Plan. Ultimately, this proposed funding methodology would be integrated into a broader Ambulatory Care Funding system currently being developed in Alberta.
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An exploratory descriptive survey of the perceptions of parents of children attending an Accident and Emergency department is described. The study examines parental perceptions of the quality of care received, and explores whether this sphere of patient care requires further attention. ⋯ The study confirmed the usefulness of auditing parents' perceptions of care. Quality aspects of care were highlighted, with lack of information and communication patterns shown to affect the perceived standard of care.
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Changing macroenvironmental factors have caused hospital administrators to reassess their positions across all service lines and market segments. This pilot study explores relationships among the service experience, satisfaction and future patronage decisions among 368 Medicare patients, an often overlooked segment, who were recent users of a hospital emergency room. Results show widespread dissatisfaction with aspects of care. Many of these patients report that they do not intend to return to the same emergency room and would discourage others from choosing it.