Articles: emergency-services.
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Overcrowding in emergency departments presents serious problems to both patients and hospital staff. At Scarborough (Ontario) General Hospital this problem was becoming potentially dangerous until a hospital committee instituted a series of changes that dramatically improved the situation. A geriatrician was appointed to assess and care for the increasing number of elderly and chronic care patients. ⋯ Surgeons agreed to perform more surgery on an outpatient basis, and the Short-Stay and Ambulatory Procedures units were expanded to handle more procedures. In addition, the implementation of a physician-managed admission system ensured the appropriate admission of patients. The entire system is monitored, and the committee meets regularly to deal with any problems.
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A retrospective audit was conducted evaluating the effectiveness of the computerized algorithm-directed triage at Brooke Army Medical Center. A total of 98,086 charts were reviewed. ⋯ Of these, 733 patients (1.2%) were retriaged from the acute care clinic to the ED. Based on these data, we conclude that the computerized algorithm-directed triage, using minimally trained personnel, appears to be an effective system.
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The demand for home attention in the special emergency service of L'Hospitalet and Cornella de Llobregat (Barcelona) was evaluated. The data from a sample of 2046 requests for home attention were assessed, corresponding to the period between July 1st, 1985, and June 30th, 1986. This sample was randomly selected from overall 28385 home visits carried out during this period. ⋯ The most common group of diseases were the respiratory conditions. 83% of patients received some type of therapy. In 12% of cases, admission to a hospital was indicated; the most common cause of admission to a hospital was indicated; the most common cause of admission was cardiovascular disease. Emphasis is made on the importance of the coordination between primary care groups and special emergency services, as well as on the need for continuing education of professionals with specialties related to the care of emergencies and pediatrics.