Estimating the Proportion of Telehealth-Able United States Emergency Department Visits.

Study Objective: We use national emergency department (ED) data to identify the proportion of "telehealth-able" ED visits, defined as potentially conductible by Video Only or Video Plus (with limited outpatient testing).

Methods: We used ED visits by patients 4 years of age and older from the 2019 National Hospital Ambulatory Medical Care Survey and applied survey weighting for national representativeness. Two raters categorized patient-described Reasons for Visit (RFV) as telehealth-able (yes, no, uncertain) for both Video Only and Video Plus visits.

Prevalence and characteristics of group standardized letters of evaluation in emergency medicine: A cross-sectional observational study.

Background: The standardized letter of evaluation (SLOE) for emergency medicine (EM) is a well-established tool for residency selection. While previous work characterizes the utility and outcomes related to SLOE use, less is known about SLOE authorship patterns and trends.

Objective: The objective was to measure the prevalence of group SLOEs in EM over time, characterize the role groups represented in group SLOEs, and compare the rating practices of groups of authors versus single authors.

Generalizability of consensus regarding standardized letters of evaluation competitiveness: A validity study in a national sample of emergency medicine faculty.

Background: Standardized letters of evaluation (SLOEs) are an important part of residency recruitment, particularly given the limited availability of other discerning factors in residency applications. While consensus regarding SLOE competitiveness has been studied within a small group of academic faculty, it remains unexplored how a more diverse group of letter readers interpret SLOEs in terms of competitiveness.

Methods: A sample of 50 real SLOEs in the new SLOE format (2022 eSLOE 2.

ChatG-PD? Comparing large language model artificial intelligence and faculty rankings of the competitiveness of standardized letters of evaluation.

Background: While faculty have previously been shown to have high levels of agreement about the competitiveness of emergency medicine (EM) standardized letters of evaluation (SLOEs), reviewing SLOEs remains a highly time-intensive process for faculty. Artificial intelligence large language models (LLMs) have shown promise for effectively analyzing large volumes of data across a variety of contexts, but their ability to interpret SLOEs is unknown.

Objective: The objective was to evaluate the ability of LLMs to rate EM SLOEs on competitiveness compared to faculty consensus and previously developed algorithms.

Faculty consensus on competitiveness for the new competency-based emergency medicine standardized letter of evaluation.

Background: Emergency medicine (EM) has introduced a new, competency-based standardized letter of evaluation (SLOE) template. While a previous version of the SLOE has been shown to promote a high degree of faculty consensus regarding competitiveness, this has not been shown for the new SLOE template.

Objective: The objective was to evaluate faculty consensus on competitiveness for the new EM SLOE 2.

Pragmatism and feasibility: A qualitative study of experiences implementing and upgrading care in geriatric emergency departments.

Objectives: Implementation and sustainability of new care processes in emergency departments (EDs) is difficult. We describe experiences of implementing geriatric care processes in EDs that upgraded their accreditation level for the Geriatric Emergency Department Accreditation (GEDA) program. These EDs can provide a model for adopting and sustaining guidelines for evidence-based geriatric care.

A guide to caring for patients who identify as transgender and gender diverse in the emergency department.

Through a review of current research, standards of care, and best practices, this paper serves as a resource for emergency physicians (EPs) caring for persons who identify as transgender and gender diverse (T/GD) in the emergency department (ED). Both patient- and physician-based research have identified existent potential knowledge gaps for EPs caring for T/GD in the ED. T/GD have negative experiences related to their gender identity when seeking emergency medical care and may even delay emergency care for fear of discrimination.

"Right now, it's kind of haphazard"-Pediatric emergency care coordinators and quality of emergency care for children: A qualitative study.

Objectives: Pediatric readiness varies widely among emergency departments (EDs). The presence of a pediatric emergency care coordinator (PECC) has been associated with improved pediatric readiness and decreased mortality, but adoption of PECCs has been limited. Our objective was to understand factors associated with PECC implementation in general EDs.

Pediatric capacity crisis: A framework and strategies to prepare for a pediatric surge.

A pediatric capacity crisis developed across the country in the Fall and Winter of 2022 due to a combination of factors, including a surge in respiratory viruses, staffing shortages, and historical closures of inpatient pediatric units. The COVID-19 pandemic and associated surge in critically ill adult patients demonstrated that health care systems and health care workers can quickly implement creative and collaborative system-wide solutions to deliver the best care possible during a capacity crisis. Similar solutions are needed to respond to future surges in pediatric volume and to maintain a high standard of care during such a surge.

Frailty assessment tools in the emergency department: A geriatric emergency department guidelines 2.0 scoping review.

Objective: Given the aging population and growing burden of frailty, we conducted this scoping review to describe the available literature regarding the use and impact of frailty assessment tools in the assessment and care of emergency department (ED) patients older than 60 years.

Methods: A search was made of the available literature using the Covidence system using various search terms. Inclusion criteria comprised peer-reviewed literature focusing on frailty screening tools used for a geriatric population (60+ years of age) presenting to EDs.

Brain versus bot: Distinguishing letters of recommendation authored by humans compared with artificial intelligence.

Objectives: Letters of recommendation (LORs) are essential within academic medicine, affecting a number of important decisions regarding advancement, yet these letters take significant amounts of time and labor to prepare. The use of generative artificial intelligence (AI) tools, such as ChatGPT, are gaining popularity for a variety of academic writing tasks and offer an innovative solution to relieve the burden of letter writing. It is yet to be determined if ChatGPT could aid in crafting LORs, particularly in high-stakes contexts like faculty promotion.

Establishing outcome-driven vital signs ranges for children in the prehospital setting.

Background: Vital signs are frequently used in pediatric prehospital assessments and guide protocol utilization. Common pediatric vital sign classification criteria identify >80% of children in the prehospital setting as having abnormal vital signs, though few receive lifesaving interventions (LSIs). We sought to identify data-driven thresholds for abnormal vital signs by evaluating their association with prehospital LSIs.

Educator's blueprint: Holistic applicant file review in undergraduate and postgraduate medical education.

Medical schools and graduate medical education programs are tasked each year with selecting the next class of trainees, often from large applicant pools with enormous quantities of data to be processed. Review of applicant files must therefore be efficient, equitable, and effective in maximizing the likelihood of trainee success and alignment with institutional missions and values. In this article, we discuss 10 strategies to optimize the file review process for trainee selection.

Emergency department course of patients with asthma receiving initial emergency medical services care-Perspectives From the National Hospital Ambulatory Medical Care Survey.

Objective: Although 911 calls for acute shortness of breath are common, the role of emergency medical services (EMS) in acute asthma care is unclear. We sought to characterize the demographics, course, and outcomes of adult emergency department (ED) patients with asthma in the United States receiving initial EMS care.

Methods: We analyzed data from the 2016-2019 National Hospital Ambulatory Medical Care Survey (NHAMCS).

Patients who use emergency medical services have greater severity of illness or injury compared to those who present to the emergency department via other means: A retrospective cohort study.

Objective: We aimed to evaluate the differences in characteristics and illness/injury severity among patients who present to the emergency department (ED) via emergency medical services (EMS) compared to patients who present via other means.

Methods: We analyzed a nationwide sample of ED visits from the 2015-2019 National Hospital Ambulatory Medical Care Survey. We excluded patients <18 or >92 years old, who eloped or left against medical advice, or who arrived via interfacility transport.

The utility of an online discussion board for reflective writing in an emergency medicine rotation.

Background: Narrative analysis and reflection have been found to support professional identity formation (PIF) and resilience among medical students. In the emergency department, students have used reflective practice to process challenging clinical experiences, such as ethical dilemmas or moral distress. An online discussion board, however, has not been described as a curricular component of emergency medicine (EM) rotations.

Evaluating changes in the emergency medical services workforce: A preliminary multistate study.

Objective: There is growing concern with the strength and stability of the emergency medical services (EMS) workforce with reports of workforce challenges in many communities in the United States. Our objective was to estimate changes in the EMS workforce by evaluating the number of clinicians who enter, stay, and leave.

Methods: A 4-year retrospective cohort evaluation of all certified EMS clinicians at the emergency medical technician (EMT) level or higher was conducted for 9 states that require national EMS certification to obtain and maintain EMS licensure.

How do current police practices impact trauma care in the prehospital setting? A scoping review.

Objective: In the United States, police are often important co-responders to 911 calls with emergency medical services for medical emergencies. To date, there remains a lack of a comprehensive understanding of the mechanisms by which police response modifies time to in-hospital medical care for traumatically injured patients. Further, it remains unclear if differentials exist within or between communities.

Factors associated with mild bronchiolitis in young infants.

Objective: Bronchiolitis within the first 3 months of life is a risk factor for more severe illness. We aimed to identify characteristics associated with mild bronchiolitis in infants ≤90 days old presenting to the emergency department (ED).

Methods: We conducted a secondary analysis of infants ≤90 days old with clinically diagnosed bronchiolitis using data from the 25th Multicenter Airway Research Collaboration prospective cohort study.

Can tablet video-based telehealth assessment of the abdomen safely determine the need for abdominal imaging? A pilot study.

Objective: There is limited evidence on the reliability of video-based physical examinations. We aimed to evaluate the safety of a remote physician-directed abdominal examination using tablet-based video.

Methods: This was a prospective observational pilot study of patients >19 years old presenting with abdominal pain to an academic emergency department July 9, 2021-December 21, 2021.