Alternative Dispositions for Emergency Department Patients

被引：6
作者：
Bukhman, Alice Kidder [1 ,2 ]
Baugh, Christopher W. [2 ]
Yun, Brian J. [3 ]
机构：
[1] Brigham & Womens Faulkner Emergency Dept, 1153 Ctr St, Boston, MA 02130 USA
[2] Brigham & Womens Hosp, Dept Emergency Med, 75 Francis St,Neville House 2nd Floor, Boston, MA 02115 USA
[3] Massachusetts Gen Hosp, Dept Emergency Med, 55 Fruit St, Boston, MA 02114 USA
来源：
EMERGENCY MEDICINE CLINICS OF NORTH AMERICA | 2020年 / 38卷 / 03期
关键词：
Alternative dispositions; Observation unit; Home hospital; Rapid follow-up clinic; Evidence-based clinical pathways; Accelerated diagnostic pathways; SHARED DECISION-MAKING; HOSPITAL-LEVEL CARE; OBSERVATION UNIT; CHEST-PAIN; RANDOMIZED-TRIAL; HOME; MANAGEMENT; FAILURE; RISK; ADMISSION;
D O I：
10.1016/j.emc.2020.04.004
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
Alternatives to inpatient admission have been shown to be safe and effective for a variety of clinical conditions and can help relieve emergency department (ED) and inpatient crowding. Evidence-based alternatives include use of rapid ED follow-up clinics, observation units, and home hospital programs. Use of accelerated diagnostic pathways and shared decision making can help support clinicians and patients in appropriately choosing an alternative disposition to traditional inpatient admission. However, many institutions struggle to fully embrace possible alternative depositions because of challenges of patient access, clinician and patient comfort with diagnostic uncertainty, and perceived medicolegal risks.
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收藏
页码：647 / +
页数：16
相关论文
共 74 条
[1]   Community paramedics treat high acuity conditions in the home: a prospective observational study [J].
Abrashkin, Karen Anna ;
Poku, Asantewaa ;
Ramjit, Alyeah ;
Washko, Jonathan ;
Zhang, Jenny ;
Guttenberg, Michael ;
Smith, Kristofer Lawrence .
BMJ SUPPORTIVE & PALLIATIVE CARE, 2024, 14 (E1) :e683-e690
[2]   SPOTLIGHT: PATIENT CENTRED CARE Decision aids that really promote shared decision making: the pace quickens [J].
Agoritsas, Thomas ;
Heen, Anja Fog ;
Brandt, Linn ;
Alonso-Coello, Pablo ;
Kristiansen, Annette ;
Akl, Elie A. ;
Neumann, Ignacio ;
Tikkinen, Kari A. O. ;
van der Weijden, Trudy ;
Elwyn, Glyn ;
Montori, Victor M. ;
Guyatt, Gordon H. ;
Vandvik, Per Olav .
BMJ-BRITISH MEDICAL JOURNAL, 2015, 350
[3]  
[Anonymous], 2015, VISION STATEMENT MOB, P1
[4]  
[Anonymous], National Hospital Ambulatory Medical Care Survey: 2016 emergency department summary tables
[5]   Clinical Outcomes and Cost Effectiveness of Accelerated Diagnostic Protocol in a Chest Pain Center Compared with Routine Care of Patients with Chest Pain [J].
Asher, Elad ;
Reuveni, Haim ;
Shlomo, Nir ;
Gerber, Yariv ;
Beigel, Roy ;
Narodetski, Michael ;
Eldar, Michael ;
Or, Jacob ;
Hod, Hanoch ;
Shamiss, Arie ;
Matetzky, Shlomi .
PLOS ONE, 2015, 10 (01)
[6]   Creation and Implementation of an Outpatient Pathway for Atrial Fibrillation in the Emergency Department Setting: Results of an Expert Panel [J].
Baugh, Christopher W. ;
Clark, Carol L. ;
Wilson, Jason W. ;
Stiell, Ian G. ;
Kocheril, Abraham G. ;
Luck, Krista K. ;
Myers, Troy D. ;
Pollack, Charles V., Jr. ;
Roumpf, Steven K. ;
Tomassoni, Gery F. ;
Williams, James M. ;
Patel, Brian B. ;
Wu, Fred ;
Pines, Jesse M. .
ACADEMIC EMERGENCY MEDICINE, 2018, 25 (09) :1065-1075
[7]  
Baugh CW, 2017, EVIDENCE BASIS OBSER
[8]   Observation Units as Substitutes for Hospitalization or Home Discharge [J].
Blecker, Saul ;
Gavin, Nicholas P. ;
Park, Hannah ;
Ladapo, Joseph A. ;
Katz, Stuart D. .
ANNALS OF EMERGENCY MEDICINE, 2016, 67 (06) :706-713
[9]   Quick diagnosis units: avoiding referrals from primary care to the ED and hospitalizations [J].
Bosch, Xavier ;
Jordan, Anna ;
Lopez-Soto, Alfonso .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2013, 31 (01) :114-123
[10]   Can an Emergency Department Observation Unit Reduce Hospital Admissions for COPD Exacerbation? [J].
Budde, Julia ;
Agarwal, Parul ;
Mazumdar, Madhu ;
Yeo, Jonathan ;
Braman, Sidney S. .
LUNG, 2018, 196 (03) :267-270
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