Do elective surgical and medical admissions impact emergency department length of stay measurements?

Abstract Background: Emergency department access block is a growing problem in emergency departments across Canada. Access block is defined as hospital occupancy >85% causing emergency department overcrowding. Hospital overcrowding leads to prolonged emergency department wait times, and delays in the transfer of admitted patients from the emergency department to inpatient beds. The relationship between elective admissions to hospital and emergency department wait times has not been adequately assessed. We undertook a simple linear regression analysis of the impact of elective admissions to hospital on emergency department length of stay. Methods: Linear regression analysis of the number of daily elective admissions to adult acute care beds in the Calgary Health Region in the year 2004 and the daily median emergency department length of stay was done to establish the relationship between elective admissions and Emergency Department length of stay. Results: 37,007 patients were admitted to adult acute care beds via the emergency department and 46,020 patients were admitted to adult acute care beds by all other routes. Regression analysis determined that there was no relationship between daily emergency department length of stay and the number of elective admissions per day. Conclusion: For the year 2004, in the Calgary Health Region, elective acute care admissions to hospital had no relationship to emergency department length of stay for patients admitted via the emergency department. Further study is required to determine causative factors that prolong Emergency Department length of stay. Emergency departments across Canada continue to struggle with the demands of providing high quality care with diminishing resources

Remittance micro-worlds and migrant infrastructure: circulations, disruptions, and the movement of money

Remittances are increasingly central to development discourses in Africa. The development sector seeks to leverage transnational migration and rapid innovations in financial technologies (fintech), to make remittance systems cheaper for end-users and less risky for states and companies. Critical scholarship, however, questions the techno-fix tendency, calling for grounded research on the intersections between remittances, technologies, and everyday life in African cities and beyond. Building on this work, we deploy the concepts of “micro-worlds” and “migrant infrastructure” to make sense of the complex networks of actors, practices, regulations, and materialities that shape remittance worlds. To ground the work, we narrate two vignettes of remittance service providers who operate in Cape Town, South Africa, serving the Congolese diaspora community. We showcase the important role of logistics companies in the “informal” provision of remittance services and the rise of fintech companies operating in the remittance space. These vignettes give substance to the messy and relational dynamics of remittance micro-worlds. This relationality allows us to see how remittances are circulations, not unidirectional flows; how they are not split between formal and informal, but in fact intersect in blurry ways; how digital technologies are central to the story of migrant infrastructures; and how migrants themselves are compositional of these networks. In doing so, we tell a more relational story about how remittance systems are constituted and configured

Troponin utilization in patients presenting with atrial fibrillation/flutter to the emergency department: retrospective chart review

Abstract Background There are few recommendations about the use of cardiac markers in the investigation and management of atrial fibrillation/flutter. Currently, it is unknown how many patients with atrial fibrillation/flutter undergo troponin testing, and how positive troponin results are managed in the emergency department. We sought to look at the emergency department troponin utilization patterns. Methods We performed a retrospective chart review of patients with atrial fibrillation/flutter presenting to the emergency department at three centers. Outcome measures included the rates of troponins ordered by emergency doctors, number of positive troponins, and those with positive troponins treated as acute coronary syndrome (ACS) by consulting services. Results Four hundred fifty-one charts were reviewed. A total of 388 (86%) of the patients had troponins ordered, 13.7% had positive results, and 4.9% were treated for ACS. Conclusions Troponin tests are ordered in a high percentage of patients with atrial fibrillation/flutter presenting to emergency departments. Five percent of our total patient cohort was diagnosed as having acute coronary syndrome by consulting services

Do elective surgical and medical admissions impact emergency department length of stay measurements?

Background: Emergency department access block is a growing problem in emergency departments across Canada. Access block is defined as hospital occupancy >85% causing emergency department overcrowding. Hospital overcrowding leads to prolonged emergency department wait times, and delays in the transfer of admitted patients from the emergency department to inpatient beds. The relationship between elective admissions to hospital and emergency department wait times has not been adequately assessed. We undertook a simple linear regression analysis of the impact of elective admissions to hospital on emergency department length of stay. Methods: Linear regression analysis of the number of daily elective admissions to adult acute care beds in the Calgary Health Region in the year 2004 and the daily median emergency department length of stay was done to establish the relationship between elective admissions and Emergency Department length of stay. Results: 37,007 patients were admitted to adult acute care beds via the emergency department and 46,020 patients were admitted to adult acute care beds by all other routes. Regression analysis determined that there was no relationship between daily emergency department length of stay and the number of elective admissions per day. Conclusion: For the year 2004, in the Calgary Health Region, elective acute care admissions to hospital had no relationship to emergency department length of stay for patients admitted via the emergency department. Further study is required to determine causative factors that prolong Emergency Department length of stay. Emergency departments across Canada continue to struggle with the demands of providing high quality care with diminishing resources