Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 7377,
    "title": "Established and Novel Initiatives to Reduce Crowding in Emergency Departments",
    "subtitle": null,
    "abstract": "Introduction: \nThe American College of Emergency Physicians (ACEP) Task Force on Boarding described high-impact initiatives to decrease crowding. Furthermore, some emergency departments (EDs) have implemented a novel initiative we term “vertical patient flow,” i.e. segmenting patients who can be safely evaluated, managed, admitted or discharged without occupying a traditional ED room. We sought to determine the degree that ACEP-identified high-impact initiatives for ED crowding and vertical patient flow have been implemented in academic EDs in the United States (U.S.).\n \nMethods: \nWe surveyed the physician leadership of all U.S. academic EDs from March to May 2010 using a 2-minute online survey. Academic ED was defined by the primary site of an emergency residency program.\n \nResults: \nWe had a response rate of 73% (106/145) and a completion rate of 71% (103/145). The most prevalent hospital-based initiative was inpatient discharge coordination (46% [47/103] of respondents) while the least fully initiated was surgical schedule smoothing (11% [11/103]). The most prevalent ED-based initiative was fast track (79% [81/103]) while the least initiated was physician triage (12% [12/103]). Vertical patient flow had been implemented in 29% (30/103) of responding EDs while an additional 41% (42/103) reported partial/in progress implementation.\n \nConclusion: \nWe found great variability in the extent academic EDs have implemented ACEP’s established high-impact ED crowding initiatives, yet most (70%) have adopted to some extent the novel initiative vertical patient flow. Future studies should examine barriers to implementing these crowding initiatives and how they affect outcomes such as patient safety, ED throughput and patient/provider satisfaction. [West J Emerg Med 2013;14(2):85-89.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 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\nNonCommercial — You may not use the material for commercial purposes.\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-nc/4.0"
    },
    "keywords": [
        {
            "word": "emergency medicine, crowding, health policy"
        },
        {
            "word": "Medicine"
        },
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "health administration"
        }
    ],
    "section": "Emergency Department Access",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/4wt9n24h",
    "frozenauthors": [
        {
            "first_name": "Shan",
            "middle_name": "W.",
            "last_name": "Liu",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Harvard Medical School, Department of Emergency\nMedicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Azita",
            "middle_name": "G.",
            "last_name": "Hamedani",
            "name_suffix": "",
            "institution": "University of Wisconsin, Department of Medicine and Public Health, Madison, Wisconsin",
            "department": "None"
        },
        {
            "first_name": "David",
            "middle_name": "F.M.",
            "last_name": "Brown",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Harvard Medical School, Department of Emergency\nMedicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Brent",
            "middle_name": "",
            "last_name": "Asplin",
            "name_suffix": "",
            "institution": "Fairview Medical Group, St. Paul, Minnesota",
            "department": "None"
        },
        {
            "first_name": "Carlos",
            "middle_name": "A.",
            "last_name": "Camargo, Jr.",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Harvard Medical School, Department of Emergency\nMedicine, Boston, Massachusetts; Harvard School of Public Health, Department of Epidemiology, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2012-03-20T17:04:36Z",
    "date_accepted": "2012-03-20T17:04:36Z",
    "date_published": "2013-01-24T21:21:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/7377/galley/4376/download/"
        }
    ]
}