Articles: emergency-services.
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The outcome of care has traditionally been defined as a "change in the patient's current and future health status that can be attributed to antecedent health care." However, this definition provides a "unidimensional view of quality." It fails to take into account the customer's attributes and the many small steps or process variances that can contribute to an unexpected outcome. This failure can be especially pronounced in the emergency department.
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To determine whether moderately to severely ill patients with acute pyelonephritis can be treated successfully on an outpatient basis, and whether any aspect of history, physical examination, or initial laboratory data predicts failure of outpatient therapy and the need for hospitalization. ⋯ In selected patients, the observation unit may be used to initiate therapy for acute pyelonephritis. Those with an adequate clinical response to initial treatment may be discharged on oral antibiotic therapy with appropriate follow-up.
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To determine the scope and magnitude of patient and visitor aggression directed toward emergency department staff. ⋯ ED violence is a significant and under-reported problem at our medium-sized university teaching hospital. These data are useful in objectively quantifying the scope of violence in our institution, and they underscore the potential risk to emergency patients, visitors, and staff. There is an acute need for additional studies in other settings so that appropriate and cost-effective security recommendations can be formulated.