Quality Assurance in the Emergency Department

Characterization of Emergency Department Quality Assurance Cases Seen Within a Midwestern United States Health System

BACKGROUND

Hospital quality-assurance (QA) processes, including peer-review committees, seek to identify high-risk areas.

PURPOSE

To characterize emergency department (ED) cases sent for QA review.

METHODS

A retrospective observational study was conducted of ED cases sent to a QA committee from November 2018 through July 2022 at three midwestern US hospitals. The QA records analyzed for these cases included the original incident report, case summary, and the committee determinations.

RESULTS

One hundred and forty-seven cases were reviewed by the ED QA Committee. The most frequent referrals came from physicians. Common diagnostic categories included infectious (21%), cardiac (16%), gastrointestinal (11%), and neurologic (10%) concerns. Of the cases, 51% were considered nonpreventable, 33% were potentially preventable, and 9% were preventable. Inpatient boarding in the ED was explicitly implicated as a contributing factor in 6% of case reports.

CONCLUSIONS

Peer physician reporting represent the largest referral source sent for review with the most frequent diagnostic categories, including infectious, cardiac, gastrointestinal, and neurological conditions. Preventable concerns were rare.

IMPLICATIONS

This study provides a better understanding of the referral sources, diagnostic categories, and committee determinations in ED quality concerns. These results can target future investigations into case reporting and patient safety.

Value of Humanized Nursing under Emergency Green Channel on Gastrointestinal Function Recovery in Patients with Acute Intestinal Obstruction after Operation

Acute intestinal obstruction (AIO) is one of the most common surgical acute abdomens. Emergency green channel refers to a fast and efficient service system provided by hospitals for critically ill patients. It is the key to ensure that emergency patients receive timely, standardized, efficient and thoughtful medical services, improve the success rate of rescue, and reduce medical risks. Acute intestinal obstruction is mainly treated by surgery in the clinic. Previous reports have shown that the application of different nursing methods in the operation of acute intestinal obstruction has different effects on the results of surgical treatment. In this study, the clinical data of 80 patients with AIO were retrospectively analyzed to explore the value of humanistic care under the emergency green channel in promoting the recovery of gastrointestinal function after AIO surgery.