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Knowledge Repository

The effect of vertical split-flow patient management on emergency department throughput and efficiency

Author(s): Garrett, J. S., Berry, C., Wong, H., Qin, H., Kline, J. A.
In some emergency departments (EDs), the severity of a patient’s condition is rated on a 5-point scale during admission using the Emergency Service Index (ESI). Under the “split-flow” model of patient triaging, patients with less-severe conditions (rated an ESI 4 or 5) are “fast tracked” so that they can be separated from patients with higher ESI scores, allowing for more efficient resource allocation for all patient treatment procedures. 
Key Point Summary

Introduction of a horizontal and vertical split flow model of emergency department patients as a response to overcrowding

Author(s): Wallingford, G., Joshi, N., Callagy, P., Stone, J., Brown, I., Shen, S.
Hospital emergency departments (EDs) strive to optimally organize patient flow so that optimal care can be delivered while patient length of stay is minimized. The emergency severity index (ESI) is a 5-point scale used to help medical staff discern the severity of patient conditions; higher ESI scores indicate less-severe medical conditions. 
Key Point Summary

The Creation of a Biocontainment Unit at a Tertiary Care Hospital: The Johns Hopkins Medicine Experience

Author(s): Garibaldi, B. T., Kelen, G. D., Brower, R. G., Bova, G., Ernst, N., Reimers, M., Langlotz, R., Gimburg, A., Iati, M., Smith, C., MacConnell, S., James, H., Lewin, J. J., Trexler, P., Black, M. A., Lynch, C., Clarke, W., Marzinke, M. A., Sokoll, L. J., Carroll, K. C., Parish, N. M., Dionne, K., Biddison, E. L. D., Gwon, H. S., Sauer, L., Hill, P., Newton, S. M., Garrett, M. R., Miller, R. G., Perl, T. M., Maragakis, L. L.
Prior to the 2014 Ebola virus disease (EVD) outbreak in West Africa, the United States had only one to three specialized biocontainment units. Once the EVD crisis began, a group of reputable American healthcare institutions worked together to renovate a deactivated clinical space into a functioning biocontainment unit (BCU).
Key Point Summary

Route complexity and simulated physical ageing negatively influence wayfinding

Author(s): Zijlstra, E., Hagedoorn, M., Krijnen, W. P., van der Schans, C. P., Mobach, M. P.
In this study, “wayfinding” is defined as determining and following a path or route between an origin and a destination. Wayfinding can be particularly difficult in complex and sometimes stressful environments like hospitals, and as hospitals continue to expand to meet increasing healthcare demands, their layouts face the possibility of becoming more difficult to navigate. Wayfinding is particularly difficult for the elderly, who may have memory issues and weakened physical abilities. Support from the environment is necessary to help elderly people function at their best, so it is important to understand what elements of the designed environment either benefit or confuse them.
Key Point Summary

Understanding Green Building Design and Healthcare Outcomes: Evidence-Based Design Analysis of an Oncology Unit

Author(s): Campion, N., Thiel, C. L., Focareta, J., Bilec, M. M.
The United States healthcare industry is a major part of the economy as well as a significant contributor to carbon dioxide emissions and other environmental issues. Green building design (GBD) attempts to offset environmental impacts of buildings, and recently designers have been combining GBD with evidence-based design (EBD) in order to create facilities that positively impact both the external and internal environment.
Key Point Summary

Ebola Holding Units at government hospitals in Sierra Leone: evidence for a flexible and effective model for safe isolation, early treatment initiation, hospital safety and health system functioning

Author(s): Johnson, O., Youkee, D., Brown, C. S., Lado, M., Wurie, A., Bash-Taqi, D., Hall, A., Hanciles, E., Kamara, I., Kamara, C., Kamboz, A., Seedat, A., Thomas, S., Kamara, T. B., Leather, A. J. M., Kargbo, B.
The outbreak of Ebola Virus Disease (EVD) in West Africa during 2014-2015 was an unprecedented modern crisis that required novel approaches to outbreak containment and management. In response, the Ministry of Health and Sanitation (MOHS) and the King’s Sierra Leone Partnership (KSLP) in Freetown, Sierra Leone, worked to develop and implement five new Ebola Holding Units (EHUs) in government hospitals, which successfully isolated 37% of the 3,097 confirmed EVD cases within the country’s Western Urban and Rural district.
Key Point Summary

Healthcare Staffs’ Experiences and Perceptions of Caring for People with Dementia in the Acute Setting: Qualitative Evidence Synthesis

Author(s): Houghton, C., Murphy, K., Brooker, D., Casey, D.
Dementia is an international health issue that greatly impacts healthcare delivery systems. Individuals with dementia have specific needs when it comes to healthcare, and it seems that, generally, acute care environments aren’t suitable for these individuals. Considering how previous studies have shown that as much as a quarter of individuals utilizing acute hospital services are likely to have dementia, the authors posit that there needs to be a shift in ethos, organization, and environment in which more appropriate care is provided to patients with dementia in acute care settings.
Key Point Summary

A Recovery-Oriented Care Approach: Weighing the Pros and Cons of a Newly Built Mental Health Facility

Author(s): Ahern, C. C., Bieling, P., McKinnon, M. C., McNeely, H. E., Langstaff, K.
An inpatient mental health hospital was renovated with a newly built environment that incorporated patient-centered, clinically informed designs in an attempt to improve overall safety and quality of care. The new designs were considerably expensive and had extensive design implications for other parts of the hospital outside of the mental health facility.
Key Point Summary

"Let's Sit Forward": Investigating Interprofessional Communication, Collaboration, Professional Roles, and Physical Space at EmergiCare

Author(s): Dean, M., Gill, R., Barbour, J. B.
Due to the fact that emergency department (ED) caregivers are constantly involved in interprofessional, knowledge-intensive conversations, effective modes of communication necessarily play a key role in promoting patient health and safety. Previous studies have explored how the physical environment directly affects modes of communication, and how these two dimensions of the healthcare environment constantly intersect with each other.
Key Point Summary

Separate Medication Preparation Rooms Reduce Interruptions and Medication Errors in the Hospital Setting: A Prospective Observational Study

Author(s): Huckels-Baumgart, S., Baumgart, A., Buschmann, U., Schüpfer, G., Manser, T.
Errors and interruptions are commonplace during medication preparation procedures in healthcare environments. One study found that one interruption occurred for every 3.2 drugs administered during nurses’ medication rounds.
Key Point Summary