Evaluating the effect of clinical decision units on patient flow in seven canadian emergency departments

Academic Emergency Medicine

Volumn 19, Issue 7, 2012, Pages 828-836

  Schull, Michael J ^a,b,c,e   Vermeulen, Marian J ^a   Stukel, Therese A ^a,b,e   Guttmann, Astrid ^a,b,d   Leaver, Chad A ^a   Rowe, Brian H ^g,h   Sales, Anne ^f,i  

^a INSTITUTE FOR CLINICAL EVALUATIVE SCIENCES   (Canada)

^b UNIVERSITY OF TORONTO   (Canada)

^c Division of Emergency Medicine   (Canada)

^d UNIVERSITY OF TORONTO   (Canada)

^e SUNNYBROOK RESEARCH INSTITUTE   (Canada)

^f HOSPITAL FOR SICK CHILDREN   (Canada)

^g Department of Emergency Medicine ^*  (Canada)

^h Public Health City of Ottawa   (Canada)

ⁱ UNIVERSITY OF ALBERTA   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CANADA; CLINICAL DECISION MAKING; CONTROLLED STUDY; EMERGENCY CARE; EMERGENCY WARD; EVALUATION; HEALTH CARE DELIVERY; HEALTH CARE SYSTEM; HOSPITAL; HOSPITAL ADMISSION; HOSPITAL READMISSION; HUMAN; LENGTH OF STAY; MAJOR CLINICAL STUDY; OUTCOME ASSESSMENT; PATIENT CARE; PRIORITY JOURNAL; RETROSPECTIVE STUDY;

CANADA; EFFICIENCY, ORGANIZATIONAL; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; LENGTH OF STAY; MALE; ORGANIZATIONAL CASE STUDIES; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); PATIENT ADMISSION; PILOT PROJECTS; RETROSPECTIVE STUDIES;

EID: 84863920915     PISSN: 10696563     EISSN: 15532712     Source Type: Journal    
DOI: 10.1111/j.1553-2712.2012.01396.x     Document Type: Article

References (22)

1. Pines JM, Hilton JA, Weber EJ, et al., International perspectives on emergency department crowding. Acad Emerg Med. 2011; 18: 1358-70.
2. Roberts MV, Baird W, Kerr P, O'Reilly S,. Can an emergency department-based clinical decision unit successfully utilize alternatives to emergency hospitalization? Eur J Emerg Med. 2010; 17: 89-96.
3. Martinez E, Reilly BM, Evans AT, Roberts RR,. The observation unit: a new interface between inpatient and outpatient care. Am J Med. 2001; 110: 274-7. (Pubitemid 32187287)
4. Bell R, Willett J, Oliver J,. Improving Access to Emergency Care: Addressing System Issues. Toronto: Ontario Hospital Association, Ontario Medical Association, Ontario Ministry of Health and Long-Term Care, 2006.
5. Ross MA, Compton S, Richardson D, et al., The use and effectiveness of an emergency department observation unit for elderly patients. Ann Emerg Med. 2003; 41: 668-77. (Pubitemid 36520246)
6. Decker WW, Smars PA, Vaidyanathan L, et al., A prospective, randomized trial of an emergency department observation unit for acute onset atrial fibrillation. Ann Emerg Med. 2008; 52: 322-8.
7. Robinson DJ, Woods PG, Snedeker CA, Lynch JH, Chambers K,. A comparison trial for stratifying intermediate-risk chest pain: benefits of emergency department observation centers. Prev Cardiol. 2002; 5: 23-30. (Pubitemid 34224495)
8. Mace SE,. Asthma therapy in the observation unit. Emerg Med Clin North Am. 2001; 19: 169-85.
9. Baugh CW, Venketesh AK, Bohan JS,. Emergency department observation units: a clinical and financial benefit for hospitals. Health Care Manage Rev. 2011; 36: 28-37.
10. Hassan TB,. Clinical decision units in the emergency department: old concepts, new paradigms, and refined gate keeping. Emerg Med J. 2003; 20: 123-5. (Pubitemid 36388875)
11. Farkouh ME, Smars PA, Reeder GS, et al., A clinical trial of a chest-pain observation unit for patients with unstable angina. Chest Pain Evaluation in the Emergency Room (CHEER) Investigators. N Engl J Med. 1998; 339: 1882-8. (Pubitemid 29013931)
12. Goodacre S, Nicholl J, Dixon S, et al., Randomised controlled trial and economic evaluation of a chest pain observation unit compared with routine care. BMJ. 2004; 328: 254.
13. Goodacre SW,. Role of the short stay observation ward in accident and emergency departments in the United Kingdom. J Accid Emerg Med. 1998; 15: 26-30.
14. Salkeld E, Leaver C, Guttmann A, et al., Barriers and facilitators to the implementation of Ontario's emergency department clinical decision unit (CDU) pilot program: a qualitative study. CJEM. 2011; 13: 363-71.
15. Hudson A,. Commentary: Ontario's efforts to reduce time spent in hospital emergency departments. Healthc Q. 2009; 12: 107-9.
16. Murray M, Bullard M, Grafstein E,. Revisions to the Canadian emergency department triage and acuity scale implementation guidelines. CJEM. 2004; 6: 421-7. (Pubitemid 40631946)
17. McCullagh P, Nelder JA,. Generalized Linear Models. New York, NY: Chapman Hall, 1989.
18. Zeger SL, Liang KY,. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986; 42: 121-30.
19. Mace SE, Graff L, Mikhail M, Ross M,. A national survey of observation units in the United States. Am J Emerg Med. 2003; 21: 529-33. (Pubitemid 37494040)
20. Iannone P, Lenzi T,. Effectiveness of a multipurpose observation unit: before and after study. Emerg Med J. 2009; 26: 407-14.
21. Canadian Institute for Health Information. CIHI Data Quality Study of Emergency Department Visits for 2004-2005: Volume II of IV-main study findings. Toronto, ON: Canadian Institute for Health Information, 2008.
22. Brook RH, McGlynn EA, Cleary PD,. Measuring quality of care. N Engl J Med. 1996; 335: 966-70.