Articles: emergency-services.
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Because of severe emergency department (ED) overcrowding, the authors initiated a program of referring certain patients who were assessed as not needing emergency care away from the ED. A selected group of patients who presented to a busy university ED were refused treatment and triaged away following a medical screening examination performed by a nurse. In this 3-year study 136,794 patients presented to the triage area in the ED, of which 21,069 (15%) were refused care and referred elsewhere. ⋯ Responses from this survey indicated that 42% of persons received care elsewhere the same day, 37% within 2 days, and 22% decided not to seek medical care. A group of 1.6% sought care at other hospital EDs for minor complaints. The authors concluded that a group of patients can be selectively triaged out of the ED without significant adverse outcomes, which may offer one approach to the problem of ED overcrowding.
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Randomized Controlled Trial Clinical Trial
Preformatted charts improve documentation in the emergency department.
To determine if the use of programmed charts with complaint-specific entry criteria results in improved documentation of patient encounters and better clinical outcome. ⋯ Programmed charts improve documentation by facilitation of the documentation process and allow more time for patient-physician interaction. Quality of documentation alone, however, is not a reliable indicator of patient outcome or of the quality of care received.
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To determine whether the test ordering of physicians working in a teaching hospital emergency department could be influenced by modification of automated laboratory order sets. ⋯ Modification of ED "standard orders" can result in reduction of laboratory use without an adverse effect on patient care.
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To assess the impact of the introduction of an emergency medicine residency program on the quality of care in an urban community hospital emergency department. ⋯ As measured by a process evaluation, documentation of the medical record, the introduction of an emergency medicine residency significantly improved the quality of care in this urban community hospital ED.
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Top Health Rec Manage · May 1992
Legal review: the medical records implications of state and federal anti-dumping provisions.
Federal and state enforcement agencies have increased their scrutiny of hospitals to make certain they are complying with anti-dumping law. Medical record practitioners can assist their institutions by providing policies that require appropriate documentation of compliance. Given the potential sanctions imposed by anti-dumping laws, these policies should be reviewed carefully by hospital administrative, medical, and legal personnel.