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{
    "pk": 15333,
    "title": "A Scoping Review of Emergency Department Discharge Risk Stratification",
    "subtitle": null,
    "abstract": "Introduction:\n Although emergency department (ED) discharge presents patient-safety challenges and opportunities, the ways in which EDs address discharge risk in the general ED population remains disparate and largely uncharacterized. In this study our goal was to conduct a review of how EDs identify and target patients at increased risk at time of discharge. \n \nMethods:\n We conducted a literature search to explore how EDs assess patient risk upon discharge, including a review of PubMed and gray literature. After independently screening articles for inclusion, we recorded study characteristics including outcome measures, patient risk factors, and tool descriptions. Based on this review and discussion among collaborators, major themes were identified.\nResults:\n PubMed search yielded 384 potentially eligible articles. After title and abstract review, we screened 235 for potential inclusion. After full text and reference review, supplemented by Google Scholar and gray literature reviews, we included 30 articles for full review. Three major themes were elucidated: 1) Multiple studies include retrospective risk assessment, whereas the use of point-of-care risk assessment tools appears limited; 2) of the point-of-care tools that exist, inputs and outcome measures varied, and few were applicable to the general ED population; and 3) while many studies describe initiatives to improve the discharge process, few describe assessment of post-discharge resource needs.\nConclusion:\n Numerous studies describe factors associated with an increased risk of readmission and adverse events after ED discharge, but few describe point-of-care tools used by physicians for the general ED population. Future work is needed to investigate standardized tools that assess ED discharge risk and patients’ needs upon ED discharge.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/33w8n8mb",
    "frozenauthors": [
        {
            "first_name": "Todd",
            "middle_name": "A.",
            "last_name": "Jaffe",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital and Brigham and Women’s Hospital, Harvard Affiliated Emergency Medicine Residency, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Daniel",
            "middle_name": "",
            "last_name": "Wang",
            "name_suffix": "",
            "institution": "Kansas City University School of Medicine, Kansas City, Missouri",
            "department": "None"
        },
        {
            "first_name": "Bosten",
            "middle_name": "",
            "last_name": "Loveless",
            "name_suffix": "",
            "institution": "Rocky Vista University College of Osteopathic Medicine, Ivins, Utah",
            "department": "None"
        },
        {
            "first_name": "Debbie",
            "middle_name": "",
            "last_name": "Lai",
            "name_suffix": "",
            "institution": "University College of London, Division of Psychology and Language Sciences, London, England",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Loesche",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital and Brigham and Women’s Hospital, Harvard Affiliated Emergency Medicine Residency, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Benjamin",
            "middle_name": "",
            "last_name": "White",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Ali",
            "middle_name": "S.",
            "last_name": "Raja",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Shuhan",
            "middle_name": "",
            "last_name": "He",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2021-04-27T16:33:14Z",
    "date_accepted": "2021-04-27T16:33:14Z",
    "date_published": "2021-09-24T00:40:08Z",
    "render_galley": null,
    "galleys": [
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            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/15333/galley/7766/download/"
        }
    ]
}