Articles: emergency-services.
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The utilization of psychiatric crisis teams in urban hospitals is well documented. However, little is reported describing patients who use crisis teams in suburban general hospital emergency rooms. This is a descriptive survey of 1707 suburban patient visits. ⋯ A regression model is used to analyze the duration of service time and utilization patterns in relation to eight variables: season, month, day, shift, diagnosis, method of payment, age, and disposition. Five predictors are identified as significantly relating to the duration of the psychiatric consultation process. These predictors may enable hospital administrators and medical staff to plan and implement psychiatric emergency room care.
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Clinical pediatrics · Jul 1993
Efficacy of a protocol to distinguish risk of serious bacterial infection in the outpatient evaluation of febrile young infants.
A study of 534 febrile infants ages 4 to 8 weeks evaluated for sepsis assessed the efficacy of the Milwaukee Protocol (MP) for selecting patients at low risk for serious bacterial infection (SBI) who might benefit from outpatient management. Two groups were compared: 1) Infants with uncompromised presentation (UP) who met all MP criteria received ceftriaxone 50 mg/kg and were discharged, then reevaluated within 24 hours. 2) Infants with compromised presentation (CP) who did not meet MP criteria were hospitalized for antibiotic therapy pending culture results. ⋯ The only UP patient with SBI was afebrile and had a negative repeat blood culture after 24 hours, and recovered with no complications. Managing UP infants as outpatients avoided 48 to 72 hours of hospitalization, decreasing health-care costs by an estimated total of $465,170.
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Qual Assur Health Care · Jun 1993
Improving quality in emergency services to reduce hospital admission.
At the Emergency Department of Udine General Hospital (Italy) a programme to reduce admissions to the Internal Medicine Department was introduced in 1991. The majority of these admissions come from the Emergency Department, where many people, often without acute conditions, claim medical care. The programme consisted in organizational, professional and economic changes. ⋯ Finally, examinations for internal medical complaints in the emergency ward, not followed by hospitalization, increased by 15.5%. These results showed a reduction in admissions to the Internal Medicine Department greater than previously planned, with an increase in the number of outpatient examinations in the emergency room not followed by admission. Further targets were planned for 1992 to increase the quality of the service.