When health care priorities are unclear: do we obtain organs or try to save lives? R. Matesanz
DOI: http://dx.doi.org/10.1016/j.ajem.2012.08.022
The American Journal of Emergency Medicine , Vol. 31 , Issue 2 ,
Published online: December 10 2012
x In the comment entitled “When health care priorities are unclear: do we obtain organs or try to save lives?,” the authors (curiously none of them is a medical doctor) review a set of ethical principles, which should be guiding the practice of donation after death has been determined by circulatory criteria in persons whose death has occurred after an unexpected out-of-hospital cardiac arrest [1].
When health care priorities are unclear: Do we obtain organs or try to save lives? Iván Ortega Deballon, David Rodríguez-Arias Vailhen, Edurne de la Plaza Horche
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.007
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: May 25 2012
x In recent years, the number of programs for organ donation after unexpected cardiac arrest (uncontrolled donation after circulatory determination of death [uDCDD]) has increased. Potential uDCDD donors have died of an unexpected loss of circulation mostly because of sudden cardiac arrest. Because circulation is lost before death is determined and long before organ procurement could begin, organs will die unless they are quickly preserved. In Spain alone, there are 7 active programs in 6 different regions and at least as many advanced projects [1].
Rescuer factors predict high-quality CPR—a manikin-based study of health care providers Chi-Chun Lin, Chan-Wei Kuo, Chip-Jin Ng, Wen-Cheng Li, Yi-Ming Weng, Jih-Chang Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.001
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 7 2015
x In the provision of high-quality cardiopulmonary resuscitation (CPR) by health care providers, factors associated with high-quality CPR should be explored.
Resource utilization and health care charges associated with the most frequent ED users Cory Ondler, G.G. Hegde, Jestin N. Carlson
DOI: http://dx.doi.org/10.1016/j.ajem.2014.07.013
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: July 29 2014
x Emergency department (ED) visits have continued to rise, and frequent ED users account for up to 8% of all ED visits. Reducing visits by frequent ED users may be one way to help reduce health care costs. We hypothesize that frequent users have unique ED utilization patterns resulting in differences in health care charges.
Costs of ED episodes of care in the United States Jessica E. Galarraga, Jesse M. Pines
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.001
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: June 6 2015
x Emergency department (ED) care is a focus of cost reduction efforts. Costs for acute care originating in the ED, including outpatient and inpatient encounters (i.e. ED episodes), have not been estimated.
Inaccuracy of patient care reports for identification of critical resuscitation events during out-of-hospital cardiac arrest Matthew L. Sundermann, David D. Salcido, Allison C. Koller, James J. Menegazzi
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.037
The American Journal of Emergency Medicine , Vol. 33 , Issue 1 ,
Published online: October 21 2014
x Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality in the United States. We sought to evaluate the accuracy of the patient care report (PCR) for detection of 2 clinically important events: return of spontaneous circulation (ROSC) and rearrest (RA).
Quick diagnosis units: avoiding referrals from primary care to the ED and hospitalizations Xavier Bosch, Anna Jordán, Alfonso López-Soto
DOI: http://dx.doi.org/10.1016/j.ajem.2012.06.013
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: September 13 2012
x The aim of the present study was to determine whether quick diagnosis units (QDUs) can safely and efficiently avoid emergency department (ED) visits and hospitalizations.
The inaccuracy of determining overcrowding status by using the National ED Overcrowding Study Tool Hao Wang, Richard D. Robinson, Kellie Bunch, Charles A. Huggins, Katherine Watson, Rani D. Jayswal, Noah C. White, Brett Banks, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2014.07.032
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: August 2 2014
x Emergency department (ED) crowding has become more common, and perceptions of crowding vary among different health care providers. The National Emergency Department Overcrowding Study (NEDOCS) tool is the most commonly used tool to estimate ED crowding but still uncertain of its reliability in different ED settings.
Emergency physician knowledge of reimbursement rates associated with emergency medical care Camille Broadwater-Hollifield, Lisa H. Gren, Christina A. Porucznik, Scott T. Youngquist, David N. Sundwall, Troy E. Madsen
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.044
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: February 5 2014
x We investigated emergency physician knowledge of the Centers for Medicare & Medicaid Services (CMS) reimbursement for common tests ordered and procedures performed in the emergency department (ED), determined the relative accuracy of their estimation, and reported the impact of perceived costs on physicians' ordering and prescribing behavior.
Outcomes of primary care patients who are frequent and persistent users of the ED Andrew S. Hwang, Shan W. Liu, Jeffrey M. Ashburner, Brandon J. Auerbach, Steven J. Atlas, Clemens S. Hong
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.042
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: May 30 2015
x Overuse of the emergency department (ED) is an ongoing issue in the United States. With a growing emphasis on reducing unnecessary health care spending, efforts have focused on decreasing the number of preventable ED visits, especially among frequent utilizers
[1,2]. Less is known about frequent utilizers who remain persistent utilizers over multiple years. Although increased access to primary care has often been cited as a solution for reducing ED use
[3-7], a growing proportion of ED visits is attributable to insured patients with a usual source of care
[8].
Medicaid beneficiaries who continue to use the ED: a focus on the Illinois Medical Home Network Crystal M. Glover, Yanina A. Purim-Shem-Tov, Tricia J. Johnson, Shital C. Shah
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.011
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 15 2015
x Frequent, nonurgent emergency department use continues to plague the American health care system through ineffective disease management and unnecessary costs. In 2012, the Illinois Medical Home Network (MHN) was implemented to, in part, reduce an overreliance on already stressed emergency departments through better care coordination and access to primary care. The purpose of this study is to characterize MHN patients and compare them with non-MHN patients for a preliminary understanding of MHN patients who visit the emergency department.
Imaging during low back pain ED visits: a claims-based descriptive analysis Erin Schlemmer, James C. Mitchiner, Michael Brown, Elizabeth Wasilevich
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.060
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 30 2014
x Low back pain (LBP) is a common reason for emergency department (ED) visits. This study aimed to determine the frequency and type of nonindicated imaging during LBP ED visits and to describe demographic and prior health care use characteristics among the nonindicated population.
Patient safety analysis of the ED care of patients with heart failure and COPD exacerbations: a multicenter prospective cohort study Lisa Calder, Sarah Tierney, Yue Jiang, Austin Gagné, Andrew Gee, Elisabeth Hobden, Christian Vaillancourt, Jeffrey Perry, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.013
The American Journal of Emergency Medicine , Vol. 32 , Issue 1 ,
Published online: October 21 2013
x For emergency department (ED) patients with acute exacerbations of heart failure and chronic obstructive pulmonary disease (COPD), we aimed to assess the adherence to evidence-based care and determine the proportion that experienced adverse events.
The CARE 2 Committee: improving efficient use of the ED through a review of high-use patients Kelly Gray-Eurom, Matthew Hale, Matthew Thomas, Colleen Kalynych
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.016
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 18 2014
x Health care expenditures in the United States have increased from 4.4% of gross domestic product in 1950 to 17.9% in 2011 [1,2]. With health care costs continuing to rise sharply, we are effectively pitting our nation's economic well-being against the health of its citizens. This is the driving factor behind health care reform, which affects all aspects of medicine including emergency care.
Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital Allyson M. Best, Cinnamon A. Dixon, W. David Kelton, Christopher J. Lindsell, Michael J. Ward
DOI: http://dx.doi.org/10.1016/j.ajem.2014.05.012
The American Journal of Emergency Medicine , Vol. 32 , Issue 8 ,
Published online: May 19 2014
x Crowding and limited resources have increased the strain on acute care facilities and emergency departments worldwide. These problems are particularly prevalent in developing countries. Discrete event simulation is a computer-based tool that can be used to estimate how changes to complex health care delivery systems such as emergency departments will affect operational performance. Using this modality, our objective was to identify operational interventions that could potentially improve patient throughput of one acute care setting in a developing country.
Prospective study of violence against ED workers Terry Kowalenko, Donna Gates, Gordon Lee Gillespie, Paul Succop, Tammy K. Mentzel
DOI: http://dx.doi.org/10.1016/j.ajem.2012.07.010
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: September 24 2012
x Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events.
The impact of race and disease on sickle cell patient wait times in the emergency department Carlton Haywood Jr., Paula Tanabe, Rakhi Naik, Mary Catherine Beach, Sophie Lanzkron
DOI: http://dx.doi.org/10.1016/j.ajem.2012.11.005
The American Journal of Emergency Medicine , Vol. 31 , Issue 4 ,
Published online: February 4 2013
x To determine whether patients with sickle cell disease (SCD) experience longer wait times to see a physician after arrival to an emergency department (ED) compared to patients with long bone fracture and patients presenting with all other possible conditions (General Patient Sample), and to attempt to disentangle the effects of race and disease status on any observed differences.
Emergency medicine in the Veterans Health Administration—results from a nationwide survey Michael J. Ward, Sean P. Collins, Jesse M. Pines, Curt Dill, Gary Tyndall, Chad S. Kessler
DOI: http://dx.doi.org/10.1016/j.ajem.2015.03.062
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: April 6 2015
x We describe emergency physician staffing, capabilities, and academic practices in US Veterans Health Administration (VHA) emergency departments (EDs).
Closing the loop: best practices for cross-setting communication at ED discharge Lorraine P. Limpahan, Rosa R. Baier, Stefan Gravenstein, Otto Liebmann, Rebekah L. Gardner
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.017
The American Journal of Emergency Medicine , Vol. 31 , Issue 9 ,
Published online: July 1 2013
x This study aimed to develop emergency department best practice guidelines for improved communication during patient care transitions.
Cost savings associated with transfer of trauma patients within an accountable care organization Brian C. Geyer, David A. Peak, George C. Velmahos, Jonathan D. Gates, Yvonne Michaud, Laurie Petrovick, Jarone Lee, Brian J. Yun, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.067
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 4 2015
x The Patient Protection and Affordable Care Act supports the establishment of accountable care organizations (ACOs) as care delivery models designed to save costs. The potential for these cost savings has been demonstrated in the primary care and inpatient populations, but not for patients with emergency conditions or traumatic injuries.
