Listed below are some articles and abstracts on topics related to enhancing emergency services. New articles and abstracts will be added to the top as published, and then moved to the appropriate section after one month.
Rowe, B. H., Guo, X., Villa-Roel, C. et al.
The Role of Triage Liaison Physicians on Mitigating Overcrowding in Emergency Departments: A Systematic Review.
Acad Emerg Med. 2011 Feb;18:111-120.
As EDs work to reduce throughput times, one effort has centered on having physicians help with the triage process. This study examined the effectiveness of triage liaison physicians (TLPs) on ED overcrowding by reviewing 28 studies in a systematic review. Although the summarized evidence suggests that having a TLP is effective in mitigating the effects of overcrowding, most of the studies were noted to have problems with methodology. They suggest that more research is required prior to widespread implementation.
Weber, E. J., Mason, S., Carter, A. et al.
Emptying the corridors of shame: Organizational lessons from England's 4-hour emergency throughput target.
Ann Emerg Med. 2011 Feb;57:79-88.e1.
This was a qualitative studies of EDs in England, where there is a requirement that 98% of patients treated must be discharged or placed in a hospital bed within 4 hours of arrival. The goal was to discern what can be learned through the process of implementing this requirement. Learnings included a need for widespread trust to support the interdependency required for success, collaborative strategies, and focus on patient safety while achieving throughput time goals. There are definite lessons here related to challenges surrounding collaboration that can be applied to achieving hospital wide goals in other settings.
Retezar, R., Bessman, E., Ding, R. et al.
The effect of triage diagnostic standing orders on emergency department treatment time.
Ann Emerg Med. 2011 Feb;57:89-99.e2.
Triage standing orders are another strategy used in many EDs to help reduce throughput times. This was a retrospective study in one academic ED, looking at the effect of standing orders for chest pain, shortness of breath, abdominal pain, or genitourinary complaints. Of 15,188 eligible patients, 25% received full triage standing orders, 56% partial standing orders, and 19% room orders. Overall, triage standing orders were associated with a 16% reduction in median treatment time, regardless of chief complaint.
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