Measurement of Cost of Boarding in the Emergency Department Using Time-Driven Activity-Based Costing.

Study Objective: Boarding admitted patients in emergency departments (EDs) is a national crisis that is worsening despite potential financial disadvantages. The objective of this study was to assess costs associated with boarding.

Methods: We conducted a prospective, observational investigation of patients admitted through an ED for management of acute stroke at a large, urban, academic, comprehensive stroke center hospital.

A Granular View of Emergency Department Length of Stay: Improving Predictive Power and Extracting Real-Time, Actionable Insights.

Study Objective: Improved understanding of factors affecting prolonged emergency department (ED) length of stay is crucial to improving patient outcomes. Our investigation builds on prior work by considering ED length of stay in operationally distinct time periods and using benchmark and novel machine learning techniques applied only to data that would be available to ED operators in real time.

Methods: This study was a retrospective review of patient visits over 1 year at 2 urban EDs, including 1 academic and 1 academically affiliated ED, and 2 suburban, community EDs.

Factors Associated with Overutilization of Computed Tomography of the Cervical Spine.

Despite the wide availability of clinical decision rules for imaging of the cervical spine after a traumatic injury (eg, NEXUS C-spine rule and Canadian C-spine rule), there is significant overutilization of computed tomography (CT) imaging in patients who are deemed to be at low risk for a clinically significant cervical spine injury by these clinical decision rules. The purpose of this study was to identify the major factors associated with the overuse of CT cervical spine imaging using a logistic regression model. This was a retrospective review of all adult patients who underwent CT cervical spine imaging for evaluation of a traumatic injury at a tertiary academic emergency department (ED) and three affiliate community EDs in January and February 2019.

Operations Factors Associated with Emergency Department Length of Stay: Analysis of a National Operations Database.

Introduction: Prolonged emergency department (ED) length of stay (LOS) has been shown to adversely affect patient care. We sought to determine factors associated with ED LOS via analysis of a large, national, ED operations database.

Methods: We performed retrospective, multivariable, linear regression modeling using the 2019 Emergency Department Benchmarking Alliance survey results to identify associated factors of ED LOS for admitted and discharged patients.

Estimates of throughput and utilization at freestanding compared to low-volume hospital-based emergency departments.

Objective: Our investigation compared throughput metrics and utilization measures for freestanding emergency departments (FSEDs) versus hospital-based emergency departments (HBEDs) of similar volumes in the United States.

Methods: This study is a cross sectional survey of 183 FSEDs and 317 HBEDs located across the United States using the Emergency Department Benchmarking Alliance (EDBA) Database. We measured common emergency department (ED) throughput metrics.

Misdiagnosed Spontaneous Carotid Cavernous Sinus Fistula.

A 63-year-old female presented to the emergency department with worsening left-sided blurry vision and diplopia. She had previously seen several physicians and had been diagnosed with common ocular conditions - keratoconus and dry eye. However, despite treatment her symptoms were worsening.