1
40
4
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Text
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<a href="http://doi.org/10.1002/emp2.12318" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/emp2.12318</a>
Pages
1297-1303
Issue
6
Volume
1
ISSN
2688-1152
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<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Update Year & Number
January 2021 List
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Summa Health Akron City Hospital
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Estimates of throughput and utilization at freestanding compared to low-volume hospital-based emergency departments.
Publisher
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Journal of the American College of Emergency Physicians Open
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
2020-12
Creator
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Dark C;Canellas M; Mangira C; Jouriles N; Simon EL
Description
An account of the resource
OBJECTIVE: Our investigation compared throughput metrics and utilization measures for freestanding emergency departments (FSEDs) versus hospital-based emergency departments (HBEDs) of similar volumes in the United States. METHODS: This study is a cross sectional survey of 183 FSEDs and 317 HBEDs located across the United States using the Emergency Department Benchmarking Alliance (EDBA) Database. We measured common emergency department (ED) throughput metrics. Primary outcomes included overall length of stay, length of stay for admitted, and length of stay for treated and released patients. Outcomes were weighted based on the proportion of ED volume per facility as per a prior pilot study. Multiple linear regression analysis was used to adjust for measured differences between FSEDs and HBEDs. The variables that were controlled for in regression analysis included geographic location of the ED (urban, suburban, and rural), percent of high acuity capacity, ED volume, percentage of patients arriving via emergency medical services (EMS), and percentage of pediatric patients. RESULTS: Nationally, the median length of stay in minutes (104.2 vs 140.0), length of stay for treated and released patients (98.6 vs 122.9), door-to-bed (4.0 vs 8.0), door-to-doctor (11.0 vs 16.0), percentage of patients admitted through the ED (4.0 vs 11.0), and percentage of patients leaving the ED without being seen (LWBS) (0.9 vs 1.5), were significantly lower at FSEDs compared to HBEDs (P < 0.0001 for all comparisons). Length of stay for admitted patients (265.9 vs 241.8) and median boarding time (96.8 vs. 71.3) were significantly lower in HBEDs compared to FSEDs. X-ray, computed tomography, and ECG utilization per 100 patients was significantly lower at the FSEDs compared to HBEDs. Multiple linear regression analysis demonstrated that the length of stay for treated and released patients was 8.67 minutes shorter for FSEDs as compared to HBEDs (95% confidence interval [CI] = -1.4 to -16.0). The length of stay for admitted patients was 44 minutes longer for FSEDs as compared to HBEDs (95% CI = 25.5 to 63.0). CONCLUSIONS: In this study of similarly sized EDs in the United States, throughput metrics for FSEDs tended to be significantly shorter from the arrival of the patient until their departure, except for patients requiring hospital admission. For measures favoring FSEDs, throughput times range from 20%-50% shorter than HBEDs.
Identifier
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<a href="http://doi.org/10.1002/emp2.12318" target="_blank" rel="noreferrer noopener">10.1002/emp2.12318</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
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journalArticle
2020
Canellas M
Dark C
Department of Emergency Medicine
January 2021 List
Jouriles N
Journal Of The American College Of Emergency Physicians Open
journalArticle
Mangira C
NEOMED College of Medicine
Simon EL
Summa Health Akron City Hospital
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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<a href="http://doi.org/10.1002/emp2.12305" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/emp2.12305</a>
Pages
1594-1601
Issue
6
Volume
1
ISSN
2688-1152
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Update Year & Number
January 2021 List
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Summa Health Akron City Hospital
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Post-traumatic stress and stress disorders during the COVID-19 pandemic: Survey of emergency physicians.
Publisher
An entity responsible for making the resource available
Journal of the American College of Emergency Physicians Open
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
2020-12
Creator
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Marco CA; Larkin GL; Feeser VR; Monti JE; Vearrier L
Description
An account of the resource
OBJECTIVE: Emergency physicians routinely encounter stressful clinical situations, including treating victims of crime, violence, and trauma; facing the deaths of patients; and delivering bad news. During a pandemic, stress may be increased for healthcare workers. This study was undertaken to identify symptoms of post-traumatic stress disorder (PTSD) among emergency physicians during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional survey was developed using the Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (DSM-5) and the PTSD Checklist for DSM-5 (PCL-5). The survey was distributed to members of the American College of Emergency Physicians from May 21, 2020, through June 22, 2020. RESULTS: Among 1300 emergency physicians, a significant number of participants (22.3%; 95% confidence interval, 20.3-24.3%) reported symptoms of stress consistent with PTSD (PCL score ≥ 33). Higher PCL-5 scores were associated with age younger than 50 years (P < 0.05) and <10 years in practice (P < 0.05). The major sources of stress identified by participants included disinformation about COVID-19, computer work/electronic medical record, personal protective equipment concerns, and workload. The most common consequences of workplace stress were feeling distant or cut off from other people and sleep disturbance, such as trouble falling or staying asleep. CONCLUSIONS: A significant number of emergency physicians reported symptoms of stress consistent with PTSD. Higher PCL-5 scores were associated with age younger than 50 years and <10 years in practice.
Identifier
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<a href="http://doi.org/10.1002/emp2.12305" target="_blank" rel="noreferrer noopener">10.1002/emp2.12305</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Format
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journalArticle
2020
Department of Emergency Medicine
Feeser VR
January 2021 List
Journal Of The American College Of Emergency Physicians Open
journalArticle
Larkin GL
Marco CA
Monti JE
NEOMED College of Medicine
Summa Health Akron City Hospital
Vearrier L
-
Text
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URL Address
<a href="http://doi.org/10.1002/emp2.12238" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/emp2.12238</a>
Pages
1669-1675
Issue
6
Volume
1
ISSN
2688-1152
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Update Year & Number
July 2021 List
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
NEOMED Student Publications
Affiliated Hospital
Cleveland Clinic Akron General Hospital
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Procedural frequency: Results from 18 academic, community and freestanding emergency departments
Publisher
An entity responsible for making the resource available
Journal Of The American College Of Emergency Physicians Open
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
2020-12
Subject
The topic of the resource
emergency medicine; ACQUISITION; DELIBERATE PRACTICE; EXPERT PERFORMANCE; MEDICINE; procedural skills; skills maintenance
Creator
An entity primarily responsible for making the resource
Do ELS; Smalley CM; Meldon SW; Borden BL; Briskin I; Muir MR; Suchan A; Delgado F; Fertel BS
Description
An account of the resource
BackgroundEmergency physicians must maintain procedural skills, but clinical opportunities may be insufficient. We sought to determine how often practicing emergency physicians in academic, community and freestanding emergency departments (EDs) perform 4 procedures: central venous catheterization (CVC), tube thoracostomy, tracheal intubation, and lumbar puncture (LP). MethodsThis was a retrospective study evaluating emergency physician procedural performance over a 12-month period. We collected data from the electronic records of 18 EDs in one healthcare system. The study EDs included higher and lower volume, academic, community and freestanding, and trauma and non-trauma centers. The main outcome measures were median number of procedures performed. We examined differences in procedural performance by physician years in practice, facility type, and trauma status. ResultsOver 12 months, 182 emergency physicians performed 1582 of 2805 procedures (56%) and supervised (resident, nurse practitioner or physician assistant) an additional 1223 of the procedures they did not perform (43%). Median (interquartile range) physician performance for each procedure was CVC 0 [0, 2], tube thoracostomy 0 [0, 0], tracheal intubation 3 [0.25, 8], and LP 0 [0, 2]. The percentage of emergency physicians who did not perform at least one of each procedure during the 1-year time frame ranged from 25.3% (tracheal intubation) to 76.4% (tube thoracostomy). Physicians who work at high-volume EDs (>50,000 visits per year) performed nearly twice as many tracheal intubations, CVCs, and LPs than those at low-volume EDs or freestanding EDs when normalized per 1000 visits. Years out of training were inversely related to total number of procedures performed. Emergency physicians at trauma centers performed almost 3 times as many tracheal intubations and almost 4 times as many CVCs compared to non-trauma centers. ConclusionIn a large healthcare system, regardless of ED type, emergency physicians infrequently performed the 4 procedures studied. Physicians in high-volume EDs, trauma centers, and recent graduates performed more procedures. Our study adds to a growing body of research that suggests clinical frequency alone may be insufficient for all emergency physicians to maintain competency.
Identifier
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<a href="http://doi.org/10.1002/emp2.12238" target="_blank" rel="noreferrer noopener">10.1002/emp2.12238</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Format
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journalArticle
2020
acquisition
Borden BL
Briskin I
Cleveland Clinic Akron General Hospital
Delgado F
DELIBERATE PRACTICE
Department of Emergency Medicine
Do ELS
Emergency Medicine
EXPERT PERFORMANCE
Fertel BS
Journal Of The American College Of Emergency Physicians Open
journalArticle
July 2021 List
Medicine
Meldon SW
Muir MR
NEOMED College of Medicine
NEOMED Student Publications
procedural skills
skills maintenance
Smalley CM
Suchan A
-
Text
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URL Address
<a href="http://doi.org/10.1002/emp2.12100" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/emp2.12100</a>
Pages
1052-1059
Issue
5
Volume
1
ISSN
2688-1152 2688-1152
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
<a href="http://neomed.idm.oclc.org/login?url=http://doi.org/10.1002/emp2.12100" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1002/emp2.12100</a>
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Update Year & Number
December 2020 List
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Cleveland Clinic Akron General Hospital
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The impact of hospital boarding on the emergency department waiting room.
Publisher
An entity responsible for making the resource available
Journal Of The American College Of Emergency Physicians Open
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
2020-10
Subject
The topic of the resource
length of stay; crowding; emergency department boarding; emergency department wait times; hospital occupancy; waiting room
Creator
An entity primarily responsible for making the resource
Smalley CM; Simon EL; Meldon SW; Muir McKinsey R; Briskin I; Crane S; Delgado F; Borden BL; Fertel BS
Description
An account of the resource
BACKGROUND: Patient boarding in the emergency department (ED) is a significant issue leading to increased morbidity/mortality, longer lengths of stay, and higher hospital costs. We examined the impact of boarding patients on the ED waiting room. Additionally, we determined whether facility type, patient acuity, time of day, or hospital occupancy impacted waiting rooms in 18 EDs across a large healthcare system. METHODS: This was a retrospective multicenter study that included all ED encounters between January 1, 2018, and September 30, 2019. Encounters with missing Emergency Severity Index (ESI) level were excluded. ESI levels were defined as high (ESI 1,2), middle (ESI 3), and low (ESI 4,5). Spearman correlation coefficients measured the relationship between boarded patients and number of patients in ED waiting room. A multivariable mixed effects model identified drivers of this relationship. RESULTS: A total of 1,134,178 encounters were included. Spearman correlation coefficient was significant between number of patients in the ED waiting room and patient boarding (0.54). For every additional patient boarded/hour, the number of patients waiting/hour in the waiting room increased by 8% (95% confidence interval [CI] = 1.08-1.09). The number of patients waiting for a room/hour was 2.28 times higher for middle than for high acuity. The number of patients in waiting room slightly decreased as hospital occupancy increased (95% CI = 0.997-0.997). CONCLUSION: Number of patients in ED waiting room are directly related to boarding times and hospital occupancy. ED waiting room times should be considered as not just an ED operational issue, but an aspect of hospital throughput.
Identifier
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<a href="http://doi.org/10.1002/emp2.12100" target="_blank" rel="noreferrer noopener">10.1002/emp2.12100</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
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journalArticle
2020
Borden BL
Briskin I
Cleveland Clinic Akron General Hospital
Crane S
Crowding
December 2020 List
Delgado F
Department of Emergency Medicine
emergency department boarding
emergency department wait times
Fertel BS
hospital occupancy
Journal Of The American College Of Emergency Physicians Open
journalArticle
Length of Stay
Meldon SW
Muir McKinsey R
NEOMED College of Medicine
Simon EL
Smalley CM
waiting room