School health professionals in New Mexico do not appear prepared to address needs of LGBTQ students. Schools should consider integrating specific content about LGBTQ health risks and health disparities in trainings regarding bullying, violence, cultural competency, and suicide prevention.

IntroductionAcademic emergency department (ED) handoffs are high-risk transfer of care events. Emergency medicine residents are inadequately trained to handle these vital transitions. We aimed to explore what modifications the I-PASS (illness severity, patient summary, action list, situation awareness and contingency plans, and synthesis by receiver) handoff system requires to be effectively modified for use in ED inter-shift handoffs.MethodsThis mixed-method needs assessment conducted at an academic ED explored the suitability of the I-PASS system for ED handoffs. We conducted a literature review, focus groups, and then a survey. We sought to identify the distinctive elements of ED handoffs and discern how these could be incorporated into the I-PASS system.ResultsFocus group participants agreed the patient summary should be adapted to include anticipated disposition of patient. Participants generally endorsed the order and content of the other elements of the I-PASS tool. The survey yielded several wording changes to reflect contextual differences. Themes from all qualitative sources converged to suggest changes for brevity and clarity. Most participants agreed that the I-PASS tool would be well suited to the ED setting.ConclusionWith modifications for context, brevity, and clarity, the I-PASS system may be well suited for application to the ED setting. This study provides qualitative data in support of using the I-PASS tool and concrete suggestions for how to modify the I-PASS tool for the ED. Implementation and outcome research is needed to investigate if the I-PASS tool is feasible and improves patient outcomes in the ED environment.

Background Early recognition of trauma patients at risk for multiple organ failure (MOF) is important to reduce the morbidity and mortality associated with MOF. The objective of the study was to externally validate the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, a six-item instrument that includes age, intubation, hematocrit, systolic blood pressure, blood urea nitrogen, and white blood cell count, which was designed to predict the development of MOF within seven days of hospitalization. Study Design Prospective multi-center study of adult trauma patients between November, 2011 and March, 2013. The primary outcome was development of MOF within seven days of hospitalization, assessed using the Sequential Organ Failure Assessment Score. Hierarchical logistic regression analysis was performed to determine associations between Denver ED TOF Score and MOF. Discrimination was assessed and quantified using a receiver operating characteristics (ROC) curve. The predictive accuracy of the Denver ED TOF score was compared to attending emergency physician estimation of the likelihood of MOF. Results We included 2,072 patients with a median age of 46 (IQR 30-61) years and 68% male. The median injury severity score was 9 (IQR 5-17) and 88% of patients had blunt mechanisms. Among participants, 1,024 patients (49%) were admitted to the intensive care unit, and 77 (4%) died. MOF occurred in 120 (6%; 95% CI: 5%-7%) patients and of these, 37 (31%; 95% CI: 23%-40%) died. The area under the ROC curve for the Denver ED TOF Score prediction of MOF was 0.89 (95% CI 0.86-0.91) and for physician estimation of the likelihood of MOF was 0.78 (95% CI 0.73-0.83). Conclusions The Denver ED TOF Score predicts the development of MOF within seven days of hospitalization. Its predictive accuracy outperformed attending emergency physician estimation of the risk of MOF.

Aside from providing awareness to future mothers and the general public, health interventions should target the specific beliefs identified in this study. Because participants identified husbands as significant referents, further studies are needed to examine the husbands' attitudes and beliefs.

There is a rising demand to expand the successful roles community health workers (CHW) offer into clinical settings (cCHW) to support patient services. Using survey data, we evaluated patient and CHW readiness and intent to adopt cCHW clinical care integration. We found CHW and patient readiness to become or utilize a cCHW significantly predicted CHW and patient intent to become or utilize a cCHW; however, in our study CHWs experienced greater readiness to serve as cCHWs than did patients to utilize cCHWs.