An Emergency Department Clinical Algorithm to Increase Early Palliative Care Consultation: Pilot Project.

The emergency department (ED) is a primary entry point of hospitals but does not have a system to identify and consult palliative care (PC) early in patients who meet criteria. To determine the measurable effects of an ED PC consultation on patients who meet criteria, hypothesizing that ED PC consultation would lead to decreased average length of stay (ALOS), average direct cost per patient, decreased number of surgeries, and radiological tests performed per patient. A physician-led data-driven evidence-based algorithm was designed and piloted with implementation in two hospitals during January-March 2019 in Orlando, FL.

The Impact of Bed Traffic Control and Improved Flow Process on Throughput Measures in a Metropolitan Emergency Department.

Introduction: ED crowding is a complex phenomenon that presents many challenges to patients, hospitals, and staff. Using Lewin's change model, we implemented an ED improvement plan, including an innovative bed traffic control and improved flow system. We hypothesized that this plan would reduce door-to-provider time and emergency medical service-offloading time, decrease the length of stay and number of patients leaving without being seen by a physician, and increase overall patient satisfaction.

Clinical Transformation Through Change Management Case Study: Chest Pain in the Emergency Department.

Introduction/background: Adults with chest pain presenting to an emergency department are high-risk and high-volume. A methodology which gathers practicing physicians together to review evidence and share practice experience to formulate a written algorithm with key decision points and measures is discussed with implementation, based on change management principles, and results.

Methods: A methodology was followed to "establish the standard-of-care".

An investigation of the neural mechanisms underlying the efficacy of the adjustable gastric band.

Background: The mechanisms via which adjustable gastric band (AGB) surgery provides effective and durable weight loss remain unclear.

Objectives: This study defines the role of sensory vagal fibers in the efficacy of the adjustable gastric banding using capsaicin to eliminate unmyelinated afferent fibers in the vagus nerve in a rodent model.

Setting: University.