Objective: The aim of this study was to describe the impact of additional medical specialists, non-emergency physicians (non-EPs), performing direct supervision or a combination of direct and indirect supervision at an EP-led emergency department (ED), on patient flow and satisfaction.
Patients And Methods: An observational, cross-sectional, three-part study was carried out including staff surveys (n=379), a before and after 16-week data collection using data of visits during the peak hours (n=5270), and patient questionnaires during 1 week before the pilot and during week 5 of the pilot. Content analysis and descriptive statistics were used for analyses.
Results: The value of being present at the ED was acknowledged by medical specialists in 49% of their surveys and 35% of the EPs' and ED nurses' surveys, especially during busy shifts. Radiologists were most often (67.3%) convinced of their value of being on-site, which was agreed upon by the ED professionals. Perceived improved quality of care, shortening of length of stay, and enhanced peer consultation were mentioned most often.During the pilot period, length of stay of boarded patients decreased from 197 min (interquartile range: 121 min) to 181 min (interquartile range: 113 min, P=0.006), and patient recommendation scores increased from -15 to +20.
Conclusion: Although limited by the mix of direct and indirect supervision, our results suggest a positive impact of additional medical specialists during busy shifts. Throughput of admitted patients and patient satisfaction improved during the pilot period. Whether these findings differ between direct supervision and combination of direct and indirect supervision by the medical specialists requires further investigation.
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http://dx.doi.org/10.1097/MEJ.0000000000000487 | DOI Listing |
Front Mol Biosci
December 2024
Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
This review provides an in-depth summary of the development of anti-cancer drugs for tumor-associated macrophages (TAMs), with a particular focus on the development and tissue specialization of macrophages, and factors influencing the polarization of M1 and M2 macrophages, and mechanistic insights underlying the targeting therapeutic approaches. TAMs, pivotal in the tumor microenvironment, exhibit notable plasticity and diverse functional roles. Influenced by the complex milieu, TAMs polarize into M1-type, which suppresses tumors, and M2-type, which promotes metastasis.
View Article and Find Full Text PDFTher Adv Infect Dis
December 2024
Division of Infectious Diseases, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Mail Stop 1186, Toledo, OH 43614, USA.
Background: Outpatient parenteral antibiotic therapy (OPAT) enhances patient safety, improves outcomes, and reduces healthcare costs by decreasing 30-day readmissions and adverse events. However, the optimal structure and follow-up protocols for OPAT programs remain undefined. Identifying high-risk patients for readmission and managing adverse drug events (ADEs) are critical components of OPAT care.
View Article and Find Full Text PDFARYA Atheroscler
January 2024
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Due to the shared risk factors between cardiovascular disease (CVD) and certain cancers such as breast cancer (BC) and colorectal cancer (CRC), our study aimed to assess the CVD risk factors among newly diagnosed patients with BC and CRC. The study utilized baseline data from the ongoing Cardiovascular Events in Breast and Colorectal Cancers (CIBC) cohort study conducted in Isfahan since 2019. Only patients who had recently been diagnosed with BC or CRC and had not undergone any treatment were included in the study.
View Article and Find Full Text PDFJ Surg Case Rep
January 2025
Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland.
The diffuse large B-cell lymphoma (DLBCL) mimicking an epidural hematoma in the cervical spine is an extremely unique case. We present a case of a 42-year-old man, who presented to the emergency department with symptoms of tetraparesis after a session of spinal manipulation therapy. magnetic resonance imaging visualized a lesion located at C3-C7 causing spinal cord compression with surrounding soft tissue edema suggesting epidural hematoma.
View Article and Find Full Text PDFBrain Spine
November 2024
ESNR Delegate, Diagnostic and Interventional Neuroradiology, Cardarelli Hospital, Naples, Italy.
Introduction: Middle Meningeal Artery Embolization (MMAE) in patients with chronic SubDural Hematoma (cSDH) is a novel treatment approach, albeit the specific role of MMAE in the treatment of cSDH is not yet defined.
Research Question: The aim of this work is to provide a consensus-based statement from a multidisciplinary panel on the current role of MMAE in patients with cSDH.
Materials And Methods: A literature search was performed using the keywords MMAE and cSDH.
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