ABSTRACT
EMS personnel in the U.S. continue to be overwhelmingly Caucasian and male, with 75% being male and 85% identifying as nonminority. While the population of the United States becomes more diverse in ethnicity, religion, and race, the EMS workforce remains largely homogenous and does not reflect the diversity of the population it serves. Given the growing diversity across the country, EMS personnel will increasingly be responding to calls for service involving patients with different cultural backgrounds than their own. This growing gap between providers and the population they serve may exacerbate already existing disparities in care.
Subject(s)
Cultural Diversity , Delivery of Health Care , Emergency Medical Services , Emergency Medical Technicians/statistics & numerical data , Educational Status , Ethnicity , Female , Humans , Male , United StatesABSTRACT
OBJECTIVE: To assess the effect of having a physician or physician's assistant (PA) as patients' first point of contact in our emergency department (ED) on the rate of leaving without being seen (LWBS) and wait time. METHODS: In before and after intervention conducted in the ED at a 265-bed community hospital, data were collected on all patients presenting to the ED during a 70-month period. A physician or PA was stationed in triage 16 hr a day. The screening process included measurement of vital signs, a brief history and physical examination, and computerized physician order entry. RESULTS: During the study period, volume increased from 86,000 to 102,000 patients per year. Monthly averages for ED visits increased 16%, admissions increased 5%, and ambulance visits increased 18%. The rate of LWBS decreased from 3.1% to 1.7%. Door-to-doctor time decreased by 14 min. CONCLUSIONS: Despite an increase in patient census, the LWBS rate and door-to-doctor time decreased. This study of one solution to the issue of ED crowding demonstrates how a process redesign can lead to successful changes in throughput metrics.
Subject(s)
Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Quality Improvement/organization & administration , Triage/organization & administration , Triage/statistics & numerical data , Crowding , Hospitals, Community , Humans , Length of Stay , Patient Admission , Physician Assistants , Physicians , Retrospective Studies , Time FactorsABSTRACT
How does fat consumption influence the consumption of companion foods such as bread? Adult restaurant goers who were randomly given olive oil for their bread used 26% more oil on each piece of bread compared to those who were given block butter, but they ended up eating 23% less bread in total. This finding illustrates one way in which fat intake can interact with the consumption of companion foods.
