About time! A scoping review of public-facing emergency department wait time displays in Canada

Rathagirishnan, Raahulan; Birchall, Isabelle; Latimer-Cheung, Amy E; Tse, Sandy; Cheung, Kevin

doi:10.1007/s43678-022-00301-4

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…During our clinical practice, we kept witnessing that patients often complained about the prolonged preoperative wait, wondering if the delay might exacerbate outcomes of the replantation, while patients and surgeons also shared an antipathy to the policy because the new protocol interfered regular working shift, arrangement of surgery, and hospitalization. Patients may also develop negative emotional status during this period, including anxiety and depression, resulting in strained relationships between doctors and patients (24). Hopefully, this study provided clinical evidence for both doctors and patients that waiting for the result of preoperative severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) detection would not change the endings of the replanted digits, since there was no significant difference in overall and leveled functional recovery as well as complication rate before and after COVID-19 virus nucleic acid testing normalization.…”

Section: Discussionmentioning

confidence: 99%

Influence on emergency digit replantation and outcome assessment after COVID-19 virus nucleic acid testing normalization

Zhang

et al. 2023

Front. Surg.

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ObjectiveThe study aims to compare the implementation and prognosis of emergency digit replantation surgery before and after normalized corona virus disease 2019 (COVID-19) nucleic acid testing for patients taking emergency operation and to explore the influence of normalized COVID-19 nucleic acid testing on replantation surgery.MethodNormalized COVID-19 nucleic acid testing for patients taking emergency operation has been carried out since 1 August 2021 at our hospital, which means each patient who needs emergency surgical treatment has to obtain either positive or negative results of COVID-19 nucleic acid before entering the operating room. This research reviewed and compared the prognosis of the injured extremity that had emergency severed digit replantation between June and September 2021, at the Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, and analyzed the impact of normalized COVID-19 nucleic acid testing on the outcome of the replanted fingers of different severity using disability of arm-shoulder-hand (DASH) and hand injury severity scoring (HISS) scoring systems.ResultsA total of 54 cases with 74 severed replanted phalanges were included replanted by the research group between 1 August and 30 September 2021, without any COVID-19 suspected/confirmed case detected. Compared with previous period (1 June to 31 July, 2021), although the interval between emergency visits and emergency replantation did increase significantly after normalized COVID-19 nucleic acid testing [(3.83 ± 0.94) to (1.77 ± 0.67) h, P < 0.05], we observed no significant difference in the improvement rate of the DASH scoring of the disabled upper extremity 3-month postoperatively (P = 0.538) nor in the complication rate (P = 0.344). Moreover, there was no significant difference in the improvement rate of the DASH scoring of the disabled upper extremity 3-month postoperatively in patients with different traumatic severities before and after normalized COVID-19 nucleic acid testing (moderate P = 0.269, severe P = 0.055, major P = 0.149).ConclusionDespite the preoperative delay, the policy of COVID-19 nucleic acid testing normalization does not have explicit influence on the short-term outcomes of emergency digit replantation surgery. With this evidence, microsurgeons could pay attention to the patients' anxiety and spend more effort in comforting them during the prolonged preoperative wait. These insights may have implications for other emergency department resource management whenever a social crisis occurs.

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Section: Discussionmentioning

confidence: 99%

Influence on emergency digit replantation and outcome assessment after COVID-19 virus nucleic acid testing normalization

Zhang

et al. 2023

Front. Surg.

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“…The authors of this review concluded that wait time reporting is emerging as a practice in Canadian health systems and research into its effectiveness is needed. 54 Virtual Pediatric ED Visits A During the early days of the COVID-19 pandemic, virtual care options emerged for services where they had not previously been used, including emergency care. At the Children's Hospital of Eastern Ontario (Ottawa) a virtual pediatric ED was developed using secure video conferencing software embedded into the hospital's EMR.…”

Section: Self-referralmentioning

confidence: 99%

Interventions Intended to Alleviate Emergency Department Overcrowding

Mason,

Secord,

MacDougall

2023

cjht

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Why Is This an Issue? Emergency department (ED) overcrowding is a known issue in Canada that puts patients’ lives and health at risk when treatment needs within the ED exceed the resources required to address them. The causes and consequences of ED overcrowding are complex, varied, and extend beyond the ED. Left unchecked, ED overcrowding contributes to a deteriorating standard of care as staff become overworked and burned out. What Are the Potential Interventions to Address ED Overcrowding? This roundup of 87 new and emerging interventions intended to alleviated ED overcrowding complements CADTH’s Emergency Department Overcrowding: An Environmental Scan of Contributing Factors and a Summary of Systematic Review Evidence on Interventions. Interventions were included in this report if they are not captured in CADTH’s complimentary report Emergency Department Overcrowding: An Environmental Scan of Contributing Factors and a Summary of Systematic Review Evidence on Interventions because they are either new or are not yet in wide use in EDs and health systems across Canada and could be reasonably be expected to affect ED overcrowding (e.g., by improving patient flow through the ED or reducing the number of people seeking care in the ED). Interventions that could address multiple causal factors (e.g., e-consult services) were also included. What Is the Potential Impact? Decreasing ED overcrowding has the potential to improve the standard of care delivered to those accessing EDs and contribute to decreasing the burden on ED staff, regardless of the intervention or which contributing factor it aims to act upon. Some interventions that can alleviate ED overcrowding also have an impact on primary and community care; bolstering preventive care, increasing access to diagnostic testing for those who need it, and improving access to health care supports can improve health outcomes. What Else Do We Need to Know? The pan-Canadian issue of ED overcrowding calls for real solutions. CADTH is examining the evidence and expert-informed considerations and producing a series of publications about the causes and consequences of, and solutions to, ED overcrowding in health care systems across the country. The interventions identified in this report may be of interest to senior health care decision-makers who are anticipating health system innovation and transformation.

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Designing a Parent-Informed Pediatric Emergency Department Wait Time App: Using Human-Centered Design to Create an Artificial Intelligence Healthcare Tool (Preprint)

Litwin,

Mohabir,

Kocak

et al. 2024

Preprint

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BACKGROUND Waiting has become an unfortunate reality for parents seeking care for their child in the emergency department (ED). Long wait times are known to increase morbidity and mortality. Providing patients with information about their wait time increases satisfaction and sense of control. There are very few patient-facing AI tools currently in use in EDs, especially tools that are designed with patients and caregivers. OBJECTIVE Our aim was to utilize insights from parents and healthcare providers to inform the design of an AI tool that provides personalized wait time and health information to parents during their child’s ED visit. METHODS The study followed a human-centered design methodology. The study was conducted in a large tertiary care, urban academic children’s hospital. Data were collected by demographic surveys, semi-structured interviews, card sorting, structured observations and prototype testing from parents and triage nurses. Quantitative data from demographic surveys and card sorting were analyzed using descriptive statistics, including means, medians and interquartile ranges. Qualitative data from semi-structured interviews and observations were analyzed using a content analysis and creating an empathy map. The analysis informed the design of the tool. The tool was implemented in the ED and improved through iterative rounds of testing and improvement. RESULTS Between May 30, 2023-August 30, 2023, 64 semi-structured interviews were conducted with parents in the waiting room and 5 interviews were conducted with triage nurses. Parents were primarily mothers (59%), college/university graduates (58%) and had a preferred language of English (80%). 100% of parents had a smart phone and 97% used apps on their smart phone. Children were a median of 7 months (IQR 4-12 months) and had a median of 4 lifetime visits to the ED (IQR 1->5). The qualitative analysis revealed three key themes. Themes informed the development of the wait time AI tool to meet the needs and preferences of parents, aiming to (1) reduce anxiety and uncertainty by providing information, (2) provide a better understanding of the ED process, and (3) communicate a sense of progress. The tool was designed to be an informative and reassuring companion to parents, offering real-time updates, educational content, and a clear visual representation of their ED journey. CONCLUSIONS This study employed a human-centred design approach to explore parents' experience waiting in the pediatric ED to develop an AI tool to improve the waiting experience. By prioritizing parents' experiences and insights, we have created a solution that addresses the logistical challenges of communicating wait times and contributes to a more compassionate and efficient healthcare environment. The implementation of this tool has given patients and families the control and certainty they were lacking by providing information about their wait time. The missing gap in developing and implementing technological innovations in the clinical space is a design approach to ensure solutions are based on clinical need, user-centeredness, and testing with patients and healthcare providers to ensure acceptability and usability.

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About time! A scoping review of public-facing emergency department wait time displays in Canada

Cited by 3 publications

References 9 publications

Influence on emergency digit replantation and outcome assessment after COVID-19 virus nucleic acid testing normalization

Influence on emergency digit replantation and outcome assessment after COVID-19 virus nucleic acid testing normalization

Interventions Intended to Alleviate Emergency Department Overcrowding

Designing a Parent-Informed Pediatric Emergency Department Wait Time App: Using Human-Centered Design to Create an Artificial Intelligence Healthcare Tool (Preprint)

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