Abstract:
OBJECTIVES:To derive a tool to determine Urgent Care Center (UCC) crowding and investigate the association between different levels of UCC overcrowding and negative patient care outcomes. DESIGN:Prospective pilot study. SETTING:Single centre study in the USA. PARTICIPANTS:3565 patients who registered at UCC during the 21-day study period were included. Patients who had no overcrowding statuses estimated due to incomplete collection of operational variables at the time of registration were excluded in this study. 3139 patients were enrolled in the final data analysis. PRIMARY AND SECONDARY OUTCOME MEASURES:A crowding estimation tool (SONET: Severely overcrowded, Overcrowded and Not overcrowded Estimation Tool) was derived using the linear regression analysis. The average length of stay (LOS) in UCC patients and the number of left without being seen (LWBS) patients were calculated and compared under the three different levels of UCC crowding. RESULTS:Four independent operational variables could affect the UCC overcrowding score including the total number of patients, the number of results pending for patients, the number of patients in the waiting room and the longest time a patient was stationed in the waiting room. In addition, UCC overcrowding was associated with longer average LOS (not overcrowded: 133±76 min, overcrowded: 169±79 min, and severely overcrowded: 196±87 min, p<0.001) and an increased number of LWBS patients (not overcrowded: 0.28±0.69 patients, overcrowded: 0.64±0.98, and severely overcrowded: 1.00±0.97). CONCLUSIONS:The overcrowding estimation tool (SONET) derived in this study might be used to determine different levels of crowding in a high volume UCC setting. It also showed that UCC overcrowding might be associated with negative patient care outcomes.
journal_name
BMJ Openjournal_title
BMJ openauthors
Wang H,Robinson RD,Cowden CD,Gorman VA,Cook CD,Gicheru EK,Schrader CD,Jayswal RD,Zenarosa NRdoi
10.1136/bmjopen-2014-006860subject
Has Abstractpub_date
2015-04-14 00:00:00pages
e006860issue
4issn
2044-6055pii
bmjopen-2014-006860journal_volume
5pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVES:Internalised homonegativity (IH) is hypothesised to be associated with HIV risk behaviour and HIV testing in men who have sex with men (MSM). We sought to determine the social and individual variables associated with IH and the associations between IH and HIV-related behaviours. DESIGN AND SETTING:We examin...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001928
更新日期:2013-02-04 00:00:00
abstract:OBJECTIVE:Recent data on sustained hypertension and obesity among school-going children and adolescents in India are limited. This study evaluates the prevalence of sustained hypertension and obesity and their risk factors among urban and rural adolescents in northern India. SETTING:A school-based, cross-sectional sur...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027134
更新日期:2019-09-08 00:00:00
abstract:OBJECTIVES:Physicians are a commonly targeted group in health research surveys, but their response rates are often relatively low. The goal of this paper was to evaluate the effect of unconditional incentives in the form of a coffee card on physician postal survey response rates. DESIGN:Following 13 key informant inte...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2014-007166
更新日期:2015-02-18 00:00:00
abstract:OBJECTIVES:To assess non-health literature, identify key strategies in promoting more networked teams and groups, apply external ideas to healthcare, and build a model based on these strategies. DESIGN:A systematic review of the literature outside of healthcare. METHOD:Searches guided by Preferred Reporting Items for...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2014-006567
更新日期:2015-09-24 00:00:00
abstract:OBJECTIVES:Understanding patients' preferences for treatment is crucial to provision of good care and shared decisions, especially when more than one treatment option exists for a given condition. One such condition is infection of the area around the prosthesis after hip replacement, which affects between 0.4% and 3% ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031645
更新日期:2020-01-21 00:00:00
abstract:INTRODUCTION:Malnutrition among children is a serious public health problem in the aftermath of any natural disaster. We will review the various nutrition interventions for children aged <5 years in countries where natural disasters occurred and analyse the effect on nutrition-related outcomes. METHODS AND ANALYSIS:We...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009525
更新日期:2015-11-30 00:00:00
abstract:OBJECTIVE:To clarify prognostic factors for idiopathic inflammatory myopathy (IIM)-associated interstitial lung disease (ILD). DESIGN:Systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation system. DATA SOURCES:Medline, EMBASE and Science Citation Index Expanded ...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2018-023998
更新日期:2018-12-16 00:00:00
abstract:OBJECTIVE:To complete an economic evaluation within a randomised controlled trial (RCT) comparing the use of an electronic discharge communication tool (eDCT) compared with usual care. SETTING:Patients being discharged from a single tertiary care centre's internal medicine Medical Teaching Units. PARTICIPANTS:Between...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-019139
更新日期:2017-12-14 00:00:00
abstract:INTRODUCTION:The association between long-chain omega-3 polyunsaturated fatty acids (PUFAs), brain health, cognitive function and mood has been the subject of intensive research. Marine-derived omega-3 PUFAs, such as docosahexaenoic acid and eicosapentaenoic acid, are highly concentrated in neuronal membranes and affec...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027167
更新日期:2019-06-22 00:00:00
abstract:OBJECTIVES:Liver disease is a major cause of morbidity and mortality in sub-Saharan Africa, but its prevalence, distribution and aetiology have not been well characterised. We therefore set out to examine liver function tests (LFTs) and liver fibrosis scores in a rural African population. DESIGN:We undertook a cross-s...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032890
更新日期:2020-03-31 00:00:00
abstract:OBJECTIVES:To estimate the incidence and epidemiology of catheter-related bloodstream infections (CRBSIs) on a national scale by using prospective epidemiological data from the Swiss Antibiotic Resistance Surveillance System (ANRESIS). DESIGN:Observational study. SETTING:National surveillance from 2008 to 2015 of acu...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-023824
更新日期:2018-12-22 00:00:00
abstract:OBJECTIVES:To explore the interactive process of sharing case stories in small-group activity in general practice. DESIGN:Qualitative focus group study. SETTING:Peer-group meetings of doctors attending specialist training or continuous medical education in general practice. PARTICIPANTS:Twenty female and 30 male doc...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001208
更新日期:2012-08-08 00:00:00
abstract:OBJECTIVES:This article summarises all the available evidence on the impact of introducing blood-based point-of-care panel testing (POCT) in ambulatory care on patient outcomes and healthcare processes. DESIGN:Systematic review and meta-analysis of randomised-controlled trials and before-after studies. DATA SOURCES:O...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032132
更新日期:2020-02-27 00:00:00
abstract:INTRODUCTION:Smoking remains the leading cause of preventable death in the USA but can be reduced through policy interventions. Computational models of smoking can provide estimates of the projected impact of tobacco control policies and can be used to inform public health decision making. We outline a protocol for sim...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019169
更新日期:2018-03-23 00:00:00
abstract:OBJECTIVE:Making the diagnosis of asthma is challenging. Guidelines recommend that clinicians identify a group at 'high probability' of asthma. High probability, however, is not numerically defined giving rise to uncertainty. The aim of this work was to build consensus on what constitutes a high probability of asthma i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034559
更新日期:2020-04-20 00:00:00
abstract:OBJECTIVES:In many current guidelines, blood pressure (BP)-lowering drug treatment for primary prevention of cardiovascular disease (CVD) is based on absolute risk. However, in clinical practice, therapeutic decisions are often based on BP levels alone. We sought to investigate which approach was superior by conducting...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-017723
更新日期:2018-03-19 00:00:00
abstract:INTRODUCTION:Cardiovascular morbidity is a major burden in patients with rheumatoid arthritis (RA). In this study, we compare the effect of a targeted, intensified, multifactorial intervention with that of conventional treatment of modifiable risk factors for cardiovascular disease (CVD) in patients with early RA fulfi...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2015-009134
更新日期:2016-04-20 00:00:00
abstract:BACKGROUND:Since the Singapore Mental Health Study in 2010 which reported a 16.0% prevalence rate for current smokers and 4.5% for nicotine dependence, new anti-smoking strategies have been implemented. The aim of this study was to compare smoking trends from the 2010 study with the second Singapore Mental Health Study...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032198
更新日期:2019-10-18 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is associated with a high risk of stroke and may often be asymptomatic. AF is commonly undiagnosed until patients present with sequelae, such as heart failure and stroke. Stroke secondary to AF is highly preventable with the use of appropriate thromboprophylaxis. Therefore, early ide...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001355
更新日期:2012-06-25 00:00:00
abstract:OBJECTIVE:This paper aims to analyse the variation in the delivery of diagnostic imaging services in order to suggest possible solutions for the reduction of waiting times, increase the quality of services and reduce financial costs. DESIGN:This study provides a logic model to manage waiting times in a regional contex...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001255
更新日期:2012-12-14 00:00:00
abstract:OBJECTIVE:This study examined the association of initial provider treatment with early and long-term opioid use in a national sample of patients with new-onset low back pain (LBP). DESIGN:A retrospective cohort study of patients with new-onset LBP from 2008 to 2013. SETTING:The study evaluated outpatient and inpatien...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028633
更新日期:2019-09-20 00:00:00
abstract:OBJECTIVE:To describe pattern 1 injuries caused by the antipersonnel improvised explosive device (AP-IED) in comparison to those previously described for antipersonnel mines (APM). DESIGN:Prospective cohort study of 100 consecutive pedestrian victims of an AP-IED, with traumatic amputation without regard for gender, n...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-014697
更新日期:2017-08-07 00:00:00
abstract:OBJECTIVE:To analyse voluntary payment reports of pharmaceutical companies to German healthcare professionals (HCPs) in 2015 and 2016 based on an industry-self-regulating transparency codex. DESIGN AND PARTICIPANTS:Cohort study of all German HCPs who voluntarily agreed that at least one payment they received in 2015 a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037395
更新日期:2020-09-17 00:00:00
abstract:OBJECTIVE:Prenatal exposure to antiepileptic drugs (AEDs) has been associated with adverse outcomes in the offspring such as congenital malformations and neuropsychiatric disorders. The objective of this study was to investigate whether prenatal exposure to AEDs is also associated with more frequent use of primary heal...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012836
更新日期:2017-01-05 00:00:00
abstract:OBJECTIVE:To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. DESIGN:Single-study economic evaluation of a cluster-controlled trial (Food Choic...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-019182
更新日期:2018-03-03 00:00:00
abstract:OBJECTIVES:To describe the clinical profile of Brazilian patients with type 2 diabetes attending the public healthcare system and identify factors associated with poor glycaemic control. DESIGN:Cross-sectional study. SETTING:14 centres in five regions of Brazil, including primary care units and outpatient clinics of ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003336
更新日期:2013-09-18 00:00:00
abstract:OBJECTIVES:Sickness absence after mild traumatic brain injury (mTBI) is frequent due to postconcussive symptoms. We examined labour market attachment following mTBI up to 5 years postinjury. DESIGN AND SETTING:Nationwide cohort study with register follow-up. PARTICIPANTS:Patients between 18 and 60 years with mTBI (In...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-026104
更新日期:2019-04-11 00:00:00
abstract:OBJECTIVES:To explore utilisation patterns of asthma medication before, during and after pregnancy as recorded in seven European population-based databases. DESIGN:A descriptive drug utilisation study. SETTING:7 electronic healthcare databases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna and Tuscany), W...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2015-009237
更新日期:2016-01-19 00:00:00
abstract:OBJECTIVE:To investigate whether red blood cell distribution width (RDW) is associated with the blood pressure (BP) reverse-dipper pattern in patients with hypertension. DESIGN:Cross-sectional study. SETTING:Single centre. PARTICIPANTS:Patients with essential hypertension were included in our study (n=708). The excl...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-010456
更新日期:2016-02-23 00:00:00
abstract:OBJECTIVE:The evaluation of discomfort in paediatric research is scarcely evidence-based. In this study, we make a start in describing children's self-reported discomfort during common medical research procedures and compare this with discomfort during dental check-ups which can be considered as a reference level of a ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-016077
更新日期:2017-08-01 00:00:00