Are reductions in emergency department length of stay associated with improvements in quality of care?

"We sought to determine whether patients seen in hospitals who had reduced overall emergency department (ED) length of stay (LOS) in the 2 years following the introduction of the Ontario Emergency Room Wait Time Strategy were more likely to experience improvements in other measures of ED quality of care for three important conditions."

Are reductions in emergency department length of stay associated with improvements in quality of care? A difference-in-differences analysis
MJ Vermeulen et al.
BMJ Qual Saf 2016;25:489-498 doi:10.1136/bmjqs-2015-004189

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Reducing blood culture contamination rates in an Emergency Department

"Current guidelines advocate a contamination rate of 2–3%. From January 2013 to November 2014 inclusive, the contamination rate was 4.74% in our Emergency Department, responsible for initial management and investigation of over 40 cases of sepsis per month. A Quality Improvement team was created to try to reduce contamination rates to the recommended target."

A change of culture: reducing blood culture contamination rates in an Emergency Department
J Bentley, S Thakore, L Muir, A Baird, J Lee
BMJ Quality Improvement Report 2016;5: doi:10.1136/bmjquality.u206760.w2754

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Knowledge Translation and Barriers to Imaging Optimization in the Emergency Department

"This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines."

Knowledge Translation and Barriers to Imaging Optimization in the Emergency Department: A Research Agenda
MA Probst
Academic Emergency Medicine 2015;22:1455–1464

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A novel approach to improving coagulation sample ordering in an emergency department

"Through a simple change in longstanding clinical practice, we were able to reduce the number of unnecessary coagulation samples sent from the emergency department."

A novel approach to improving coagulation sample ordering in an emergency department
E Murphy, S MacGlone, C McGroarty
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u204785.w2857

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The Flex Track: Flexible Partitioning between Low- and High-Acuity Areas of an Emergency Department

"Using discrete-event simulation, we have shown that adding some flexibility into bed allocation between low- and high-acuity can provide substantial reductions in overall patient waiting and a more efficient ED [Emergency Department]."

The Flex Track: Flexible Partitioning between Low- and High-Acuity Areas of an Emergency Department
LF Laker, CM Froehle, CJ Lindsell, MJ Ward
Annals of Emergency Medicine. 2014; 64(6): 591–603. doi:  10.1016/j.annemergmed.2014.05.031

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Management of transient ischaemic attacks in the emergency department

"This educational intervention has improved patient safety and has been seen to be sustainable on the second improvement cycle."

Management of transient ischaemic attacks in the emergency department: a quality improvement project
S Wydall, A Gordon, M Sims
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u205496.w2443

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Behavior change interventions when implementing multi-professional teamwork at an emergency department

"This study highlights how teamwork can be implemented and suggests that clear Direction (i.e. engaged management that is specific regarding both why and how teamwork should be performed, alignment between teamwork and other processes and initiatives) and allocation of resources for ongoing problem-solving and adaptation are important ingredients for effective implementation of teamwork."

Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: a comparative case study
M Frykman, H Hasson, ÅM Athlin, U von Thiele Schwarz
BMC Health Services Research, 2014, 14: 218

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Evaluating adverse drug event reporting in administrative data from emergency departments

"Adverse drug events to outpatient medications were underreported in emergency department administrative data compared to the number of adverse drug events diagnosed and recorded at the point-of-care."

Evaluating adverse drug event reporting in administrative data from emergency departments: a validation study
CM Hohl, L Kuramoto, E Yu, B Rogula, J Stausberg, B Sobolev
BMC Health Services Research, 2013, 13:473

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Waiting management at the emergency department

"To manage non-acceptable waiting is a driving force behind much of the staff behavior at an Emergency Department."

Waiting management at the emergency department - a grounded theory study
L Burstrom, B Starrin, ML Engstrom, H Thulesius
BMC Health Services Research, 2013, 13:95

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Emergency department visits for nonurgent conditions

"If health plans, policy makers, and providers want to reduce use of the ED for nonurgent problems, they must ensure that their interventions are evidence- based and tailored to address the needs and concerns of the populations they are designed to serve."

Emergency department visits for nonurgent conditions
L Uscher-Pines, J Pines, A Kellermann, E Gillen, A Mehrotra
The American Journal of Managed Care, 2013, 19(1):47-59

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Making ambulance handover delays a thing of the past

"In this report, we have looked at ambulance turnaround delays on a national and whole system basis for the first time. "

Zero tolerance: making ambulance handover delays a thing of the past
NHS Confederation, Association of Ambulance Chief Executives
December 2012

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Driving improvement in A & E services

"Trusts have reduced reattendance rates by providing comprehensive information and followup advice when patients leave A & E."

Driving improvement in A & E services
Foundation Trust Network
October 2012

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Consumer quality index (CQ-index) in an accident and emergency department

"The Consumer Quality index for the accident and emergency department measures patients' experiences of A&E healthcare performance."

The consumer quality index (CQ-index) in an accident and emergency department: development and first evaluation
N Bos, LM Sturms, AJP Schrijvers, HF van Stel
BMC Health Services Research, 2012, 12:284

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Effectiveness and safety of emergency department short stay units

"Limited evidence from 1 systematic review indicates that SSUs may lead to improved patient satisfaction in specific clinical contexts."

The effectiveness and safety of emergency department short stay units: a rapid review
KJ Konnyu, E Kwok, B Skidmore, D Moher
Open Medicine, 2012, 6(1):e10

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