System Level Informatics to Improve Triage Practices for Sickle Cell Disease Vaso-Occlusive Crisis: A Cluster Randomized Controlled Trial

Linton, Elizabeth A.; Souffront, Kimberly; Gordon, Lauren; Loo, George; Genes, Nicholas; Glassberg, Jeffrey

doi:10.1016/j.jen.2021.05.007

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…15 A study by Linton and colleagues addressed this gap by developing an emergency severity index (ESI) clinical decision tool that would allow patients with SCD to be appropriately triaged by nurses in the ED. 16 The results from the study showed that patients with SCD who had an ESI score of 2 or higher in the intervention group were triaged at a higher rate compared with the control group (64.95% vs 35.05%, P < 0.003). 16 This study has paved the way for ED staff to receive advanced education and training leading to improved care.…”

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confidence: 87%

“…16 The results from the study showed that patients with SCD who had an ESI score of 2 or higher in the intervention group were triaged at a higher rate compared with the control group (64.95% vs 35.05%, P < 0.003). 16 This study has paved the way for ED staff to receive advanced education and training leading to improved care. Furthermore, the National Heart, Lung, and Blood Institute (NHLBI) guidelines has recommended that patients with SCD should be assigned an ESI score of 2 on a 5-point scale, with 1 being the most urgent and 5 being the least urgent.…”

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confidence: 87%

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Roles of Pharmacists in the Management of Sickle Cell Disease in Adults: A Narrative Review

Weaver,

Nonyel,

Rungkitwattanakul

2024

Journal of Pharmacy Technology

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Background: Sickle cell disease (SCD) is an autosomal, recessive, genetic condition of the sickle cell genes. It affects about 100 000 people in the United States where an estimated 1 out of every 365 black children and 1 out of every 13 black children will be born with SCD and sickle cell trait, respectively. Severe and unpredictable pain crisis are the leading cause of emergency department visit for adult patients with SCD and account for 90% of inpatient hospitalizations and 85% of all acute medical care, as well as high usage of medical resources. The care of patients with SCD is complex and requires a multidisciplinary approach. With a few pharmacotherapeutic options to reduce SCD complications and pain episodes, the role of pharmacists in the medication management is unclear. This article aims to outline the potential role of pharmacists in SCD management. Data sources: The authors searched Medline, PubMed, EMBASE, and Scopus from January 1, 1990 to August 31, 2022, for primary literature that assessed the role of pharmacists in managing patients with SCD. Results: The authors identified relevant studies and summarized the role of pharmacists in SCD management. Conclusions: Access to comprehensive health care is essential to ensure that patients with SCD have decreased hospitalizations and good health-related quality of life. Pharmacists are an integral part of the multidisciplinary health-care team and can help patients with SCD navigate the complexities of health care. Pharmacists are medication experts who are positioned to ensure comprehensive care in the acute and chronic SCD management.

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confidence: 87%

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confidence: 87%

Roles of Pharmacists in the Management of Sickle Cell Disease in Adults: A Narrative Review

Weaver,

Nonyel,

Rungkitwattanakul

2024

Journal of Pharmacy Technology

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“…One study that evaluated the impact of CDS on pediatric transfusion practices, utilizing a user-centered design, observed a reduction in ordering errors and inappropriate transfusion rates [36]. Linton et al also found a significant percentage increase in SCD patients receiving proper triage assignments when CDS was utilized in their study [37]. Triage nurses favored the tool, and it helped improve their triage practices for SCD patients in the emergency department.…”

Section: Effectiveness Of Cds Tools In the Management Of Scdmentioning

confidence: 99%

“…CDS tools have proven effective for improving transfusion practices, properly triaging patients, identifying respiratory abnormalities, and minimizing adverse drug reactions with pain medications among pediatric patients [36][37][38][39], emphasizing the need to incorporate more CDS approaches into diverse aspects of patient care, even at patients' homes and at the community level. Although chelation therapy helps address the accompanying complications of iron overload from chronic transfusions [34], it is noteworthy that some chelating agents have significant adverse effects.…”

Section: Public Health Implicationsmentioning

confidence: 99%

The Effectiveness of Common Interventions in the Management of Sickle Cell Disease in Primary Care Settings: A Review

Mbaezue,

Okafor,

Nkwocha

et al. 2023

Cureus

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Sickle cell disease (SCD), a chronic condition that affects men and women equally, continues to present a public health burden in the United States due to its associated morbidity and complications. Despite advances in medical knowledge and the design of novel therapies for managing the disease, its burden remains compounded because of increasing rates of immigration arising from global displacements and economic unrest in many countries. We thus conducted a comprehensive literature review of publications from 2000 to 2022 to gather guidelines on managing SCD, with a search through four databases, PubMed, Embase, Google Scholar, and Cochrane; 42 articles met the final inclusion criteria after the full-text article screening process. In the United States healthcare system, primary care physicians (PCPs) are generally providers who cater to the lifelong management of chronic medical conditions, SCD not being an exception. While more SCD patients now present to primary care clinics, many PCPs still lack the confidence and adequate experience necessary to manage the condition effectively. The gap created by the shortage of PCPs extensively equipped to provide comprehensive SCD care leads to poor health outcomes for patients. It is imperative now more than ever to continue to raise awareness about this condition at the provider level, to ensure that patients receive well-rounded care to improve their quality of life and clinical outcomes. Providing up-to-date knowledge about existing and novel therapies and/or modalities of SCD treatment would undoubtedly equip the PCPs with self-assurance to manage the condition adeptly. Thus, we explore various public health interventions such as hydroxyurea therapy, pneumococcal vaccination, penicillin therapy, iron chelation therapy, and clinical decision support tools that have been implemented in primary healthcare settings and shown to be effective in improving SCD care. We also discuss recent advancements that can lead to improved outcomes for SCD patients in the future.

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Electronic medical information systems and timeliness of care in the emergency department: a scoping review

Lacasse,

Hendel,

Farhat

et al. 2024

Discov Health Systems

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Background Although many emergency department (ED) settings have implemented an electronic medical information system (EMIS) and EMIS tools in an effort to improve timeliness of care outcomes, there remains a paucity of scientific information on this topic. We therefore performed a scoping review to describe the range of EMIS interventions and their impacts on time-based outcomes in the ED. Methods We searched four bibliographic databases to identify potentially relevant records published after 2014 in English. Two reviewers assessed records for eligibility using a two-step screening process. We then extracted data on the type of EMIS, outcomes assessed, and reported results. Findings were summarized in tabular form and grouped by time-based outcome. Results Twenty-five studies met the eligibility criteria, with approximately half being retrospective studies. Interventions varied among studies; they generally included a new or updated EMIS, EMIS tools related to disease diagnosis and/or management, triage tools, or health information exchange platforms. Included studies compared interventions with relevant comparator groups, such as prior versions of an EMIS, absence of an EMIS, pen-and-paper documentation, and/or communication via telephone and fax. The most common outcomes reported were length of stay (n = 17 studies) and time to medication (n = 6 studies), followed by time to order, time to provider, and time from result to disposition. Reported effects of the interventions were generally inconsistent, showing either improvements, delays, or no change in examined outcomes. Conclusions Additional research is needed to determine how electronic medical information may be used in the ED to improve timeliness of care. Findings from this review can be used to inform future systematic reviews that evaluate the impact of these systems and tools on specific quality of care measures.

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System Level Informatics to Improve Triage Practices for Sickle Cell Disease Vaso-Occlusive Crisis: A Cluster Randomized Controlled Trial

Cited by 6 publications

References 23 publications

Roles of Pharmacists in the Management of Sickle Cell Disease in Adults: A Narrative Review

Roles of Pharmacists in the Management of Sickle Cell Disease in Adults: A Narrative Review

The Effectiveness of Common Interventions in the Management of Sickle Cell Disease in Primary Care Settings: A Review

Electronic medical information systems and timeliness of care in the emergency department: a scoping review

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