Pediatric ED Transitions in Care
Dr. Cristina Zeretzke MD
Email zeretzke@ufl.edu
Phone
(504) 239-1262
Faculty Department/Division
Emergency Medicine
This project is primarily:
Clinical
Research Project Description:
This QI project is specifically looking at ways ED transfers to Inpatient Hospital Care is performed, It will look at common barriers and delays into why patients are not roomed more quickly. This project is being performed in other units of care such as the Pediatric ICU. In this specific QI, our team has identified potential barriers to rapid rooming once the decision to admit from the Pediatric Emergency Dept. to the pediatric inpatient unit. Our team is multi-diciplinary and includes residents, nursing staff, charge nursing staff and attendings in the pediatric ED. We will be reviewing nursing reports, patient satisfaction scores, as well as overall daily admit data from our current census. We have also reviewed interventions to change dashboard data that will be viewed from the floor and the ED. In additional a survey tool is being used that will be distributed to all ED and pediatric floor nurses as well as all pediatric residents.
Does this project have an international component or travel?
No
If your project has an international component please give details (where, when, data collection involved, etc.):
none
The relationship among ED staffing models, cost utilization, and patient outcomes
Name:
Dr. Charles Hwang
Email
hwang.c@ufl.edu
Phone
(352) 265-5911
Faculty Department/Division
Emergency Medicine
This project is primarily:
CQI
Research Project Description:
As our emergency departments cope with increasing volumes, acuity, and costs, hospitals have come up with creative ways to manage patient flow with strategies to improve throughput and modify staffing models. These changes in staffing models incorporate residents and mid-level providers (advanced practice registered nurses and physician assistants) to augment the delivery of medical care and enhance patient throughput. Similar staffing model changes have been made throughout the breadth of medical care delivery, extending from in-hospital to clinic medicine, procedural specialties to non-procedural specialties, and various levels of care from intensive care units to emergency departments and medical wards.
Little research has been performed on differences in outcomes among different types of providers, which may have significant implications for patient care and resource utilization. The overall goal of this project is to characterize pre-defined outcomes (e.g., rates of return admission, patient death within 48 hours, upgrade in care within 6 hours, etc.) based on provider level (e.g. attending-only, resident with attending, mid-level independently, and mid-level with direct attending supervision). To the authors’ best knowledge, the outcomes amongst these different provider paradigms are poorly characterized; it is unclear whether any differences exist with respect to cost-effectiveness (e.g., inappropriate or superfluous lab or imaging orders, etc.) or medical outcomes (e.g., rates of return visit and subsequent admission within 48 hours for a similar complaint, patient death within 48 hours of admission, patient death within 48 hours of discharge, patient decompensation within 6 hours of admission, etc.). This study will be a retrospective review of ED patient charts arriving with specific chief complaints over a three year period.
Does this project have an international component or travel?
No
If your project has an international component please give details (where, when, data collection involved, etc.):
N/A
Does symptom onset matter in the assessment of acute coronary syndrome?
Dr. Brandon Allen
Email
brandonrallen@ufl.edu
Phone
(954) 675-4321
Faculty Department/Division
Emergency Medicine
This project is primarily:
Clinical
Research Project Description:
The goal of this proposal is to improve care for patients with symptoms concerning for acute coronary syndrome (ACS). This is a high priority for the U.S. In the U.S., care patterns for the evaluation of ED patients with possible ACS are heterogeneous, inefficient, and costly. Chest pain, a symptom that often prompts an evaluation for ACS, accounts for 7-9 million annual U.S. ED visits. Over 50% of ED patients with chest pain are hospitalized for lengthy diagnostic evaluations. However, less than 10% of these patients are ultimately diagnosed with ACS. Recent advances in chest pain risk stratification, such as accelerated diagnostic protocols (ADPs) and high sensitivity cardiac troponin assays (hs-cTn), have increased the precision of MI diagnosis and exclusion during the ED visit. This project will retrospectively analyze the value of reported symptom onset time and outcomes in an ED-based cohort by utilizing the time of arrival to the ED as time zero (T0) in replacement of the patient’s reported symptom onset time and assess for Major Adverse Cardiac Events (MACE) with associated statistical and clinical relevance.
Does this project have an international component or travel?
No