The association between emergency department (ED) overcrowding and poor patient outcomes is well described, with recent work suggesting that the phenomenon causes delays in time-sensitive interventions, such as resuscitation. Even though most researchers agree on fact admitted patients boarding ED a major contributing factor to overcrowding, little explicitly addresses whether in-hospital occupancy associated probability of being from ED. objective present study investigate an...

Intravenous thrombolysis is a well-established treatment for acute ischemic stroke. Our aim was to quantify the effect of each minute delay in door-to-needle time (DNT) on 90-day survival, intracerebral hemorrhagic complication <36 hours, and functional outcomes at 3 months, routine clinical practice.Our nationwide registry-based study included 14 132 adult patient admissions with stroke receiving intravenous from 2010 2017. Outcomes were analyzed using multivariable logistic regression,...

Previous work has suggested that given a hospital's need to admit more patients from the emergency department (ED), high inpatient bed occupancy may encourage premature hospital discharges favor for beds over patients' medical interests. We argue effects of such action would be measurable as greater proportion unplanned readmissions among discharged when was full than not. In response, present study tested this hypothesis by investigating association between at time discharge and 30-day...

The aim of this work was to train machine learning models identify patients at end life with clinically meaningful diagnostic accuracy, using 30-day mortality in discharged from the emergency department (ED) as a proxy.Retrospective, population-based registry study.Swedish health services.All cause mortality.Electronic records (EHRs) and administrative data were used six supervised predict all-cause within 30 days EDs southern Sweden, Europe.The trained 65 776 ED visits validated on 55 164...

A possible downstream effect of high in-hospital bed occupancy is that patients in the emergency department (ED) who would benefit from care are denied admission. The present study aimed at evaluating this hypothesis through investigating associations between time presentation ED and probability for unplanned 72-hour (72-h) revisits to among discharged index. second outcome was 72-h resulting All visits a 420-bed hospital southern Sweden 1 January 2011 31 December 2012, which did not result...

It is well established that managing patients with acute stroke in dedicated units associated improved functioning and survival. The objectives of this study are to investigate whether less likely be directly admitted a unit from the Emergency Department when hospital beds scarce measure variation across hospitals terms outcome.This register comprised data on 14 out 72 Swedish 2011-2014. Data were linked administrative daily bed occupancy (measured at 6 a.m.). Logistic regression analysis...

A recent study of acute stroke patients in England and Wales revealed several patterns temporal variation quality care. We hypothesized that similar would be present Sweden aimed to describe these patterns. Additionally, we investigate whether hospital type conferred resilience against variation.We conducted this nationwide registry-based using data from the Swedish Stroke Register (Riksstroke) including all adult registered with between 2011 2015. Outcomes included process measures...

Objectives: To update the sets of patient-centric outcomes measures ("standard-sets") developed by not-for-profit organization ICHOM to become more readily applicable in patients with multimorbidity and facilitate their implementation health information systems. that end we set out (i) harmonize previously defined separately for different conditions, (ii) create clinical models from measures, (iii) restructure annotation make machine-readable. Materials Methods: First, harmonized semantic...

Objectives: Procedural interoperability in health care requires information support and monitoring of a common work practice. Our aim was to devise an model for complete annotation actions clinical pathways that allow use multiple plans concomitantly as several partial processes underlie any composite process. Materials Methods: The development the based on integration defined protocol patients with chronic obstructive pulmonary disease observational study cohort characterization at group...

Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced several Swedish EDs. short, means that nurse separately evaluates patients who present the Department either refers them care or discharges home, if their complaints are perceived as being low acuity. The aim study elucidate whether high levels in-hospital bed occupancy associated with decreased permeability...

The purpose of this paper is to investigate the appropriateness hospitalized patients’ level care as assessed by their treating physicians. study was conducted a qualitative study, based on questionnaire. suggests that physicians generally believe patients who occupy in-hospital beds are cared for at appropriate care. It worth note relatively large fraction have had medical needs attended to, but remain while waiting municipal action. Successful downsizing bed-capacity assumes either segment...

In 2005, the Advanced Life Support (ALS) teams delivering pre-hospital care in RegionSkane southern Sweden received additional support by physicians, who were part of "Pre-hospital acute teams" (PHAT). The study objective is to compare incidence medical interventions for trauma-patients cared conventional ALS and patients PHAT.Trauma with Injury Severity Score (ISS) >9 identified retrospectively national quality registry KVITTRA at three hospitals RegionSkane, time period October 2005...

Background and Purpose: Studies of monthly variation in acute stroke care have led to conflicting results. Our objective was study longitudinal trends quality patient survival following stroke. Methods: nationwide included all adult patients (≥18 years) with stroke, (ischemic or hemorrhagic) admitted Swedish hospitals from 2011 2016, that were registered The Stroke Register (Riksstroke). We studied how month admission affected survival. also resilience this among different levels...

Introduction: It is firmly established that management of acute stroke at dedicated units (SU) improves functioning and survival. Although guidelines recommend SU admission as 1 st level care for all patients with stroke, quality registers show many are treated non-SU wards. Previous studies have shown there different patterns time impose an effect on a multitude outcomes patients. The primary objective this study was to investigate if were any temporal variations direct admissions...