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Acute Crit Care. 2020;35(1):1–9.\nHecker A, Hecker B, Hecker M, Riedel JG, Weigand MA, Padberg W. Acute abdominal compartment syndrome: current diagnostic and therapeutic options. Langenbecks Arch Surg. 2016;401(1):15–24.\nKim H, Paek JH, Song JH, Lee H, Jhee JH, Park S, et al. Permissive fluid volume in adult patients undergoing extracorporeal membrane oxygenation treatment. Crit Care. 2018;22(1):270.\nDjordjevic I, Maier-Trauth J, Gerfer S, Elskamp M, Muehlbauer T, Maul A, et al. Fluid management in veno-arterial extracorporeal membrane oxygenation therapy-analysis of an experimental pig model. J Clin Med. 2023;12(16):5330.\nShah SK, Jimenez F, Letourneau PA, Walker PA, Moore-Olufemi SD, Stewart RH, et al. Strategies for modulating the inflammatory response after decompression from abdominal compartment syndrome. Scand J Trauma Resusc Emerg Med. 2012;20:25.\nAl-Fares A, Pettenuzzo T, Del Sorbo L. Extracorporeal life support and systemic inflammation. 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C: The Global Burden of Disease: 2004 Update. World Health Organization, Geneva; 2008.\nMichaud CM, Murray CJ, Bloom BR: Burden of disease - implications for future research. JAMA 2001, 285: 535–539. 10.1001\u002Fjama.285.5.535\nWorld development report 1993–investing in health Commun Dis Rep CDR Wkly 1993,3(30):137.\nHsai R, Razzak J, Tsai AC, Hirshon JM: Placing emergency care on the global agenda. Annals of Emerg Med 2010, 56: 142–149. 10.1016\u002Fj.annemergmed.2010.01.013\nForan M, Levine A, Lippert S, Chan J, Aschkenasy M, Arnold K, Rosborough S: International emergency medicine review: A review of the literature from 2009. Acad Emerg Med 2011, 18: 86–92. 10.1111\u002Fj.1553-2712.2010.00961.x\nAmeratunga S, Hijar M, Norton R: Road-traffic injuries: confronting disparities to address a global-health problem. Lancet 2006,367(9521):1533–1540. 10.1016\u002FS0140-6736(06)68654-6\nMoshiro C, Heuch I, Astrom AN, Setel P, Hemed Y, Kvale G: Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey. BMC Publ Health 2005, 5: 11. 10.1186\u002F1471-2458-5-11\nHolder Y, Peden M, Krug E: Injury Surveillance Guidelines. World Health Organization, Geneva; 2001.\n: World report on road traffic injury prevention. World Health Organization, Geneva; 2004.\nWorster A, Haines T: Advanced statistics: Understanding medical record review (MRR) studies. Acad Emerg Med 2004, 11: 187–192.\nTeam RDC: R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna; 2011.\nHsia RY, Ozgediz D, Mutto M, Jayaraman S, Kyamanywa P, Kobusingye OC: Epidemiology of injuries presenting to the national hospital in Kampala, Uganda: implications for research and policy. Int J Emerg Med 2010,3(3):165–172. 10.1007\u002Fs12245-010-0200-1\nMock CN, Abantanga F, Cummings P, Koepsell TD: Incidence and outcome of injury in Ghana: a community-based survey. Bull World Health Organ 1999,77(12):955–964.\nMock CN, Adzotor E, Denno D, Conklin E, Rivara F: Admissions for injury at a rural hospital in Ghana: implications for prevention in the developing world. Am J Public Health 1995,85(7):927–931. 10.2105\u002FAJPH.85.7.927\nForjuoh SN: Traffic-related injury prevention interventions for low-income countries. Inj Control Saf Promot 2003,10(1–2):109–118.\nNantulya VM, Reich MR: Equity dimensions of road traffic injuries in low- and middle-income countries. Inj Control Saf Promot 2003,10(1–2):13–20.\nBooysen FR: “Adding insult to injury”: Poverty and injury in South Africa. Stud Econ Econ 2004,28(2):13–22.\nSoderlund N, Zwi AB: Traffic-related mortality in industrialized and less developed countries. Bull World Health Organ 1995,73(2):175–182.\nSuriyawongpaisal P, Kanchanasut S: Road traffic injuries in Thailand: trends, selected underlying determinants and status of intervention. Inj Control Saf Promot 2003,10(1–2):95–104.\nNantulya VM, Sleet DA, Reich MR, Rosenberg M, Peden M, Waxweiler R: Introduction: the global challenge of road traffic injuries: can we achieve equity in safety? Inj Control Saf Promot 2003,10(1–2):3–7.\nRazzak JA, Sasser SM, Kellermann AL: Injury prevention and other international public health initiatives. Emerg Med Clin North Am 2005,23(1):85–98. 10.1016\u002Fj.emc.2004.09.008\nAli J, Adam R, Butler AK: Trauma outcome improves following the advanced trauma life support program in a developing country. J Trauma 1993, 34: 890–899. 10.1097\u002F00005373-199306000-00022\nCubbin C, Smith GS: Socioeconomic inequalities in injury: critical issues in design and analysis. Annu Rev Public Health 2002, 23: 349–375. 10.1146\u002Fannurev.publhealth.23.100901.140548\nOdero W, Garner P, Zwi A: Road traffic injuries in developing countries: a comprehensive review of epidemiological studies. Trop Med Int Health 1997,2(5):445–460. 10.1111\u002Fj.1365-3156.1997.tb00167.x",{"EN":555},"Injuries represent a significant and growing public health concern in the developing world, yet their impact on patients and the emergency health-care system in the countries of East Africa has received limited attention. This study evaluates the magnitude and scope of injury related disorders in the population presenting to a referral hospital emergency department in northern Tanzania. A retrospective chart review of patients presenting to the emergency department at Kilimanjaro Christian Medical Centre was performed. A standardized data collection form was used for data abstraction from the emergency department logbook and the complete medical record for all injured patients. Patient demographics, mechanism of injury, location, type and outcomes were recorded. Ten thousand six hundred twenty-two patients presented to the emergency department for evaluation and treatment during the 7-month study period. One thousand two hundred twenty-four patients (11.5%) had injuries. Males and individuals aged 15 to 44 years were most frequently injured, representing 73.4% and 57.8%, respectively. Road traffic injuries were the most common mechanism of injury, representing 43.9% of injuries. Head injuries (36.5%) and extremity injuries (59.5%) were the most common location of injury. The majority of injured patients, 59.3%, were admitted from the emergency department to the hospital wards, and 5.6%, required admission to an intensive care unit. Death occurred in 5.4% of injured patients. These data give a detailed and more robust picture of the patient demographics, mechanisms of injury, types of injury and patient outcomes from similar resource-limited settings.",{"EN":557},"Analysis of traumatic injuries presenting to a referral hospital emergency department in Moshi, 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A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S et al (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34(6):1589–1596\nHouck PM, Bratzler DW, Nsa W, Ma A, Bartlett JG (2004) Timing of antibiotic administration and outcomes for Medicare patients hospitalized with community-acquired pneumonia. Arch Intern Med 164(6):637–644\nMeehan TP, Fine MJ, Krumholz HM, Scinto JD, Galusha DH, Mockalis JT et al (1997) Quality of care, process, and outcomes in elderly patients with pneumonia. JAMA 278(23):2080–2084\nProulx N, Frechette D, Toye B, Chan J, Kravcik S (2005) Delays in the administration of antibiotics are associated with mortality from adult acute bacterial meningitis. QJM 98(4):291–298\nZiss DR, Stowers A, Feild C (2003) Community-acquired pneumonia: compliance with centers for Medicare and Medicaid services, national guidelines, and factors associated with outcome. South Med J 96(10):949–959\nBattleman DS, Callahan M, Thaler HT (2002) Rapid antibiotic delivery and appropriate antibiotic selection reduce length of hospital stay of patients with community-acquired pneumonia: link between quality of care and resource utilization. Arch Intern Med 162(6):682–688\nHoogewerf M, Oosterheert JJ, Hak E, Hoepelman IM, Bonten MJ (2006) Prognostic factors for early clinical failure in patients with severe community-acquired pneumonia. Clin Microbiol Infect 12(11):1097–1104\nFan JS, Kao WF, Yen DH, Wang LM, Huang CI, Lee CH (2007) Risk factors and prognostic predictors of unexpected intensive care unit admission within 3 days after ED discharge. Am J Emerg Med 25(9):1009–1014\nGao H, McDonnell A, Harrison DA, Moore T, Adam S, Daly K et al (2007) Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward. Intensive Care Med 33(4):667–679\nSogaard M, Schonheyder HC, Riis A, Sorensen HT, Norgaard M (2008) Short-term mortality in relation to age and comorbidity in older adults with community-acquired bacteremia: a population-based cohort study. J Am Geriatr Soc 56(9):1593–1600\nHoogendoorn M, van’t Wout JW, Schijf V, van Dissel JT (2002) [Predictive value of chills in patients presenting with fever to urgent care department]. Ned Tijdschr Geneeskd 146(3):116–120\nTokuda Y, Miyasato H, Stein GH (2005) A simple prediction algorithm for bacteraemia in patients with acute febrile illness. QJM 98(11):813–820\nEhrenstein BP, Ehrenstein V, Henke C, Linde HJ, Salzberger B, Scholmerich J et al (2008) Risk factors for negative blood cultures in adult medical inpatients–a retrospective analysis. BMC Infect Dis 8:148\nJover F, Cuadrado JM, Andreu L, Martinez S, Canizares R, de la Tabla VO et al (2008) A comparative study of bacteremic and non-bacteremic pneumococcal pneumonia. Eur J Intern Med 19(1):15–21\nBarlow G, Nathwani D, Williams F, Ogston S, Winter J, Jones M et al (2007) Reducing door-to-antibiotic time in community-acquired pneumonia: Controlled before-and-after evaluation and cost-effectiveness analysis. Thorax 62(1):67–74\nJones AE, Yiannibas V, Johnson C, Kline JA (2006) Emergency department hypotension predicts sudden unexpected in-hospital mortality: a prospective cohort study. Chest 130(4):941–946\nHallerbach M, Francoeur A, Pomerantz SC, Oliner C, Morris DL, Eiger G et al (2008) Patterns and predictors of early hospital readmission in patients with congestive heart failure. Am J Med Qual 23(1):18–23\nAlmagro P, Barreiro B, de Ochoa EA, Quintana S, Rodriguez CM, Heredia JL et al (2006) Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease. Respiration 73(3):311–317\nJasti H, Mortensen EM, Obrosky DS, Kapoor WN, Fine MJ (2008) Causes and risk factors for rehospitalization of patients hospitalized with community-acquired pneumonia. Clin Infect Dis 46(4):550–556\nJencks SF, Williams MV, Coleman EA (2009) Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med 360(14):1418–1428\nStanley A, Graham N, Parrish A (2008) A review of internal medicine re-admissions in a peri-urban South African hospital. S Afr Med J 98(4):291–294\nHenckaerts L, Nielsen KR, Steffensen R, Van SK, Mathieu C, Giulietti A et al (2009) Polymorphisms in innate immunity genes predispose to bacteremia and death in the medical intensive care unit. Crit Care Med 37(1):192–193",{"EN":718},"Patients who are admitted with a suspicion of a severe infection usually enter the hospital through the emergency department (ED). The recognition of prognostic factors in an early stage affects further treatment and might improve clinical outcomes. We examined possible prognostic factors for four important outcomes: intensive care unit (ICU) admission, positive blood cultures, mortality and re-admission. All adult patients arriving at the ED with a suspected infection for whom admittance and intravenous (iv) antibiotics were indicated were included between March and December 2006. Possible prognostic variables were obtained from medical history, physical examination and laboratory results during the ED presentation. Data were analysed using logistic regression analysis. A total of 295 ED patients were evaluated, of whom 27 were referred to the ICU, 62 had a positive blood culture, 16 died and 48 were re-admitted. In multivariate analysis, patients with a respiration rate of >25\u002Fmin were at higher risk for ICU admission. Patients with a positive blood culture had a higher heart rate and a higher percentage of segmented neutrophils. Patients who died during admission were more likely to be older, confused and had lower blood pressure. Patients who were re-admitted within 30 days were more likely to be male, younger and less likely to have a positive blood culture. Routine clinical and biochemical information can be used to predict ICU admission, the presence of bacteraemia, mortality and re-admission (within 30 days) and should be taken into consideration for treatment decisions.",{"EN":720},"Prognostic factors for important clinical outcomes in patients with a severe infection",{"VOID":722},"10.1007\u002Fs12245-010-0220-x","https:\u002F\u002Fintjem.biomedcentral.com\u002Farticles\u002F10.1007\u002Fs12245-010-0220-x",[725,740,755,777],{"id":726,"sortIndex":243,"researcher":18,"roles":727,"affiliations":728,"properties":737},"3fff5ca2-fb80-4632-bd61-10f86a205d82",[424],[729],{"id":18,"sortIndex":19,"affiliation":730,"properties":18},{"id":731,"createTime":732,"updateTime":732,"relativeEntities":733,"slug":18,"properties":734,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"46def017-ee86-46c5-8fa4-3da5612a9275","2024-01-29T14:30:32.522+00:00",[],{"title":735},{"VI":736},"Department of Infectious Diseases, Tropical Medicine & AIDS, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands",{"title":738},{"VI":739},"Suzanne E. Geerlings",{"id":741,"sortIndex":242,"researcher":18,"roles":742,"affiliations":743,"properties":752},"e10679ee-e5ad-472e-baa9-5238478d35b7",[424],[744],{"id":18,"sortIndex":19,"affiliation":745,"properties":18},{"id":746,"createTime":747,"updateTime":747,"relativeEntities":748,"slug":18,"properties":749,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"99890f1c-df6a-4d3f-8ad2-ebad4e9baba7","2023-12-11T22:45:24.412+00:00",[],{"title":750},{"VI":751},"Department of Surgery, Trauma Unit, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands",{"title":753},{"VI":754},"Jan S. Luitse",{"id":756,"sortIndex":19,"researcher":18,"roles":757,"affiliations":758,"properties":774},"fb174cce-08c6-4aca-8fad-b3634d77786c",[424],[759,764],{"id":18,"sortIndex":19,"affiliation":760,"properties":18},{"id":731,"createTime":732,"updateTime":732,"relativeEntities":761,"slug":18,"properties":762,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},[],{"title":763},{"VI":736},{"id":765,"sortIndex":244,"affiliation":766,"properties":773},"e0be7dd5-d2ac-4869-9cf2-637447f0b19d",{"id":767,"createTime":768,"updateTime":768,"relativeEntities":769,"slug":18,"properties":770,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"34dc0b2c-40e0-4de9-a6bd-2bd664a1b004","2023-12-11T23:49:10.272+00:00",[],{"title":771},{"VI":772},"Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, Amsterdam, The Netherlands",{},{"title":775},{"VI":776},"Charlotte F. J. van Tuijn",{"id":778,"sortIndex":244,"researcher":18,"roles":779,"affiliations":780,"properties":786},"f3a8f2ce-fb57-4e97-b50d-d1ce602ceb7b",[424],[781],{"id":18,"sortIndex":19,"affiliation":782,"properties":18},{"id":731,"createTime":732,"updateTime":732,"relativeEntities":783,"slug":18,"properties":784,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},[],{"title":785},{"VI":736},{"title":787},{"VI":788},"Maria Prins",{"url":723,"publisher":790,"properties":817},{"id":6,"createTime":7,"updateTime":8,"relativeEntities":791,"slug":10,"properties":792,"entityType":16,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19,"subjectFields":795,"manageAffiliations":796,"indexDatabases":797,"url":18,"thumbnailPath":18,"statistic":812,"gsStatistic":18,"type":18,"analyzePriority":18},[],{"eissn":793,"title":794},{"VOID":13},{"EN":15},[],[],[798,805],{"id":74,"indexDatabase":799,"url":89,"indexYears":18,"academicFieldIds":804,"indexDatabaseRanking":18},{"id":76,"createTime":77,"updateTime":78,"relativeEntities":800,"label":801,"description":802,"key":85,"publicationTags":803,"standard":18},[],{"EN":81,"VI":81},{"VI":83,"EN":84},[87,88],[91],{"id":55,"indexDatabase":806,"url":68,"indexYears":69,"academicFieldIds":811,"indexDatabaseRanking":72},{"id":57,"createTime":58,"updateTime":59,"relativeEntities":807,"label":808,"description":809,"key":65,"publicationTags":810,"standard":18},[],{"EN":62,"VI":62},{"EN":62,"VI":64},[67],[71],{"impactFactor":19,"impactFactorByYear":813,"i10Index":103,"i10IndexLast5Year":40,"totalPublication":104,"totalPublicationByYear":814,"totalCitation":118,"totalCitationByYear":815,"totalCitationPerPublication":133,"totalCitationPerPublicationByYear":816,"hindexLast5Year":150,"hindex":150},{"2012":94,"2013":95,"2014":96,"2015":97,"2016":96,"2017":98,"2018":99,"2019":98,"2020":97,"2021":100,"2022":101,"2023":102},{"2008":106,"2009":107,"2010":108,"2011":109,"2012":110,"2013":111,"2014":107,"2015":112,"2016":113,"2017":114,"2018":115,"2019":116,"2020":112,"2021":117,"2022":103,"2023":106,"2024":111},{"2008":120,"2009":121,"2010":122,"2011":123,"2012":124,"2013":125,"2014":126,"2015":127,"2016":128,"2017":129,"2018":106,"2019":128,"2020":130,"2021":131,"2022":132},{"2008":135,"2009":136,"2010":137,"2011":138,"2012":139,"2013":140,"2014":141,"2015":142,"2016":143,"2017":144,"2018":145,"2019":146,"2020":147,"2021":148,"2022":149},{"volume":818,"pages":819},{"VOID":238},{"VOID":820},"293-298","2010-08-21",2010,{"id":824,"createTime":825,"updateTime":826,"relativeEntities":827,"slug":828,"properties":829,"entityType":176,"verifyStatus":177,"verifyTime":842,"verifyNote":178,"syncStatus":17,"languages":18,"translateLanguages":843,"viewCount":19,"primaryUrl":845,"fullTextUrl":18,"authors":846,"publicationType":203,"publisherRelationship":894,"citationCount":18,"citationInfo":18,"publishDate":927,"publishYear":928,"citationAnalyzeStatus":17,"lastCitationAnalyze":18,"indexDatabases":18,"openAccess":18,"references":18,"isForceReanalyzing":286},"f5e6dfa0-6b55-47c2-9b40-eb10b04b7383","2023-12-24T03:01:25.398+00:00","2025-01-18T23:46:53.022+00:00",[],"The-impact-of-a-multimodal-intervention-on-emergency-department-crowding-and-patient-flow",{"references":830,"abstract":832,"title":835,"doi":838,"keywords":840},{"VOID":831},"Bernstein SL, Aronsky D, Duseja R, et al. The effect of emergency department crowding on clinically oriented outcomes. Acad Emerg Med. 2009;16:1–10.\nCarter EJ, Pouch SM, Larson EL. The relationship between emergency department crowding and patient outcomes: a systematic review. J Nurs Scholarsh. 2014;46:106–15.\nJohnson KD, Winkelman C. The effect of emergency department crowding on patient outcomes: a literature review. Adv Emerg Nurs J. 2011;33:39–54.\nFalvo T, Grove L, Stachura R, et al. The opportunity loss of boarding admitted patients in the emergency department. Acad Emerg Med. 2007;14:332–7.\nMoskop JC, Sklar DP, Geiderman JM, et al. Emergency department crowding, part 1--concept, causes, and moral consequences. Ann Emerg Med. 2009;53:605–11.\nAsplin BR. Measuring crowding: time for a paradigm shift. Acad Emerg Med. 2006;13:459–61.\nRutherford PA, Provost LP, Kotagal UR, Luther K, Anderson A. Achieving Hospital-wide Patient Flow. IHI White Paper. Cambridge: Institute for Healthcare Improvement; 2017. Available at www.ihi.org.\nBoyle A. Crowding in emergency departments: guidance from CEM emphasises system-wide solutions. Emerg Med J. 2015;32:92.\nRichardson DB, Brockman K, Abigail A, et al. Effects of a hospital-wide intervention on emergency department crowding and quality: a prospective study. Emerg Med Australas. 2017;29:415–20.\nBonalumi NM, Bhattacharya A, Edwards C, et al. Impact of a planned workflow change: super track improves quality and service for low-acuity patients at an inner-city hospital. J Emerg Nurs. 2017;43:114–25.\nDucharme J, Alder RJ, Pelletier C, et al. The impact on patient flow after the integration of nurse practitioners and physician assistants in 6 Ontario emergency departments. CJEM. 2009;11:455–61.\nElder E, Johnston AN, Crilly J. Review article: systematic review of three key strategies designed to improve patient flow through the emergency department. Emerg Med Australas. 2015;27:394–404.\nMuller K, Chee Z, Doan Q. Using nurse practitioners to optimize patient flow in a pediatric emergency department. Pediatr Emerg Care. 2018;34:396–9.\nAbdulwahid MA, Booth A, Kuczawski M, et al. The impact of senior doctor assessment at triage on emergency department performance measures: systematic review and meta-analysis of comparative studies. Emerg Med J. 2016;33:504–13.\nLi CJ, Syue YJ, Tsai TC, et al. The impact of emergency physician seniority on clinical efficiency, emergency department resource use, patient outcomes, and disposition accuracy. Medicine (Baltimore). 2016;95:e2706.\nSoremekun OA, Capp R, Biddinger PD, et al. Impact of physician screening in the emergency department on patient flow. J Emerg Med. 2012;43:509–15.\nWhite AL, Armstrong PA, Thakore S. Impact of senior clinical review on patient disposition from the emergency department. Emerg Med J. 2010;27:262–5 296.\nAmaratunga T, Dobranowski J. Systematic review of the application of lean and six sigma quality improvement methodologies in radiology. J Am Coll Radiol. 2016;13:1088–95.\nEl Sayed MJ, El-Eid GR, Saliba M, et al. Improving emergency department door to doctor time and process reliability: a successful implementation of lean methodology. Medicine (Baltimore). 2015;94:e1679.\nHitti EA, El-Eid GR, Tamim H, et al. Improving emergency department radiology transportation time: a successful implementation of lean methodology. BMC Health Serv Res. 2017;17:625.\nVermeulen MJ, Stukel TA, Guttmann A, et al. Evaluation of an emergency department lean process improvement program to reduce length of stay. Ann Emerg Med. 2014;64:427–38.\nOdom NT, Babb M, Velez L, et al. Patient progression: a hospital-wide, multi-disciplinary, data-driven approach to moving patients safely, timely & efficiently. Stud Health Technol Inform. 2018;250:178–81.\nHigginson I. Emergency department crowding. Emerg Med J. 2012;29:437–43.\nGravel J, Gouin S, Carriere B, et al. Unfavourable outcome for children leaving the emergency department without being seen by a physician. CJEM. 2013;15:289–99.\nHuggins C, Robinson RD, Knowles H, et al. Large observational study on risks predicting emergency department return visits and associated disposition deviations. Clin Exp Emerg Med. 2019;6:144–51.\nvan der Linden MC. Emergency department crowding: factors influencing flow. Amsterdam: University of Amsterdam; 2015.\nvan der Linden N, van der Linden MC, Richards JR, et al. Effects of emergency department crowding on the delivery of timely care in an inner-city hospital in the Netherlands. Eur J Emerg Med. 2015;23:337–43.\nvan der Linden MC, de Beaufort RAY, Meylaerts SAG, et al. The impact of medical specialist staffing on emergency department patient flow and satisfaction. Eur J Emerg Med. 2017;26:47–52.\nvan der Linden MC, van den Brand CL, van den Wijngaard IR, et al. A dedicated neurologist at the emergency department during out-of-office hours decreases patients’ length of stay and admission percentages. J Neurol. 2018;265:535–41.\nvan der Linden MC, Van LM, Gaakeer MI, et al. A different crowd, a different crowding level? The predefined thresholds of crowding scales may not be optimal for all emergency departments. Int Emerg Nurs. 2018;41:25–30.\nWeiss SJ, Derlet R, Arndahl J, et al. Estimating the degree of emergency department overcrowding in academic medical centers: results of the national ED overcrowding study (NEDOCS). Acad Emerg Med. 2004;11:38–50.\nVize R. The Winter’s Tale; Leadership lessons from Emergency Departments under pressure. London: Institute of Healthcare Management; 2018.\nChang AM, Lin A, Fu R, et al. Associations of emergency department length of stay with publicly reported quality-of-care measures. Acad Emerg Med. 2017;24:246–50.\nAckroyd-Stolarz S, Read GJ, Mackinnon NJ, et al. The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study. BMJ Qual Saf. 2011;20:564–9.",{"EN":833,"VI":834},"The objective of this study is to assess the impact of a multimodal intervention on emergency department (ED) crowding and patient flow in a Dutch level 1 trauma center. In this cross-sectional study, we compare ED crowding and patient flow between a 9-month pre-intervention period and a 9-month intervention period, during peak hours and overall (24\u002F7). The multimodal intervention included (1) adding an emergency nurse practitioner (ENP) and (2) five medical specialists during peak hours to the 24\u002F7 available emergency physicians (EPs), (3) a Lean programme to improve radiology turnaround times, and (4) extending the admission offices’ openings hours. Crowding is measured with the modified National ED OverCrowding Score (mNEDOCS). Furthermore, radiology turnaround times, patients’ length of stay (LOS), proportion of patients leaving without being seen (LWBS) by a medical provider, and unscheduled representations are assessed. The number of ED visits were grossly similar in the two periods during peak hours (15,558 ED visits in the pre-intervention period and 15,550 in the intervention period) and overall (31,891 ED visits in the pre-intervention period vs. 32,121 in the intervention period). During peak hours, ED crowding fell from 18.6% (pre-intervention period) to 3.5% (intervention period), radiology turnaround times decreased from an average of 91 min (interquartile range 45–256 min) to 50 min (IQR 30–106 min., p \u003C 0.001) and LOS reduced with 13 min per patient from 167 to 154 min (p \u003C 0.001). For surgery, neurology and cardiology patients, LOS reduced significantly (with 17 min, 25 min, and 8 min. respectively), while not changing for internal medicine patients. Overall, crowding, radiology turnaround times and LOS also decreased. Less patients LWBS in the intervention period (270 patients vs. 348 patients, p \u003C 0.001) and less patients represented unscheduled within 1 week after the initial ED visit: 864 (2.7%) in the pre-intervention period vs. 645 (2.0%) patients in the intervention period, p \u003C 0.001. In this hospital, a multimodal intervention successfully reduces crowding, radiology turnaround times, patients’ LOS, number of patients LWBS and the number of unscheduled return visits, suggesting improved ED processes. Further research is required on total costs of care and long-term effects.","Mục tiêu của nghiên cứu này là đánh giá tác động của một can thiệp đa phương thức lên tình trạng quá tải tại khoa cấp cứu (ED) và dòng chảy bệnh nhân tại một trung tâm chấn thương hạng 1 ở Hà Lan. Trong nghiên cứu cắt ngang này, chúng tôi so sánh tình trạng quá tải tại ED và dòng chảy bệnh nhân giữa một khoảng thời gian 9 tháng trước can thiệp và 9 tháng trong thời gian can thiệp, trong giờ cao điểm và tổng thể (24\u002F7). Can thiệp đa phương thức bao gồm (1) bổ sung một điều dưỡng cấp cứu (ENP) và (2) năm chuyên gia y tế trong giờ cao điểm để làm việc cùng với các bác sĩ cấp cứu (EPs) có sẵn 24\u002F7; (3) chương trình Lean nhằm cải thiện thời gian xử lý hình ảnh; và (4) kéo dài thời gian mở cửa văn phòng tiếp nhận. Tình trạng quá tải được đo lường bằng Thang điểm Quá tải Quốc gia tại Khoa Cấp cứu đã được chỉnh sửa (mNEDOCS). Hơn nữa, thời gian xử lý hình ảnh, thời gian nằm viện (LOS) của bệnh nhân, tỷ lệ bệnh nhân bỏ đi mà không được khám (LWBS) bởi nhà cung cấp y tế, và số lần tái khám không theo lịch được đánh giá. Số lượt thăm khám tại ED là tương đồng nhau giữa hai giai đoạn trong giờ cao điểm (15.558 lượt khám trong giai đoạn trước can thiệp và 15.550 lượt trong giai đoạn can thiệp) và tổng thể (31.891 lượt khám trong giai đoạn trước can thiệp so với 32.121 lượt trong giai đoạn can thiệp). Trong giờ cao điểm, tình trạng quá tải tại ED giảm từ 18,6% (giai đoạn trước can thiệp) xuống còn 3,5% (giai đoạn can thiệp), thời gian xử lý hình ảnh giảm từ trung bình 91 phút (khoảng tứ phân 45–256 phút) xuống 50 phút (IQR 30–106 phút, p \u003C 0,001) và thời gian nằm viện giảm 13 phút mỗi bệnh nhân từ 167 xuống 154 phút (p \u003C 0,001). Đối với bệnh nhân phẫu thuật, thần kinh và tim mạch, thời gian nằm viện giảm đáng kể (17 phút, 25 phút và 8 phút tương ứng), trong khi không thay đổi đối với bệnh nhân nội khoa. Tóm lại, tình trạng quá tải, thời gian xử lý hình ảnh và thời gian nằm viện cũng giảm. Số lượng bệnh nhân LWBS trong giai đoạn can thiệp cũng giảm (270 bệnh nhân so với 348 bệnh nhân, p \u003C 0,001) và số lượng bệnh nhân tái khám không theo lịch trong vòng 1 tuần sau lần khám ED đầu tiên giảm: 864 (2,7%) trong giai đoạn trước can thiệp so với 645 (2,0%) bệnh nhân trong giai đoạn can thiệp, p \u003C 0,001. Tại bệnh viện này, một can thiệp đa phương thức đã thành công trong việc giảm tình trạng quá tải, thời gian xử lý hình ảnh, thời gian nằm viện của bệnh nhân, số lượng bệnh nhân LWBS và số lần tái khám không theo lịch, cho thấy quy trình tại ED đã được cải thiện. Nghiên cứu tiếp theo là cần thiết để đánh giá tổng chi phí chăm sóc và tác động lâu dài.",{"EN":836,"VI":837},"The impact of a multimodal intervention on emergency department crowding and patient flow","Ảnh hưởng của can thiệp đa phương thức đến tình trạng quá tải và dòng bệnh nhân tại khoa cấp cứu",{"VOID":839},"10.1186\u002Fs12245-019-0238-7",{"VI":841},"can thiệp đa phương thức, khoa cấp cứu, tình trạng quá tải, dòng chảy bệnh nhân, thời gian nằm viện","2025-01-14T11:19:02.145+00:00",[844],"VI","https:\u002F\u002Fintjem.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs12245-019-0238-7",[847,862,879],{"id":848,"sortIndex":244,"researcher":18,"roles":849,"affiliations":850,"properties":859},"9f29f1fc-ef8e-4bc9-993b-7681ae2e7383",[424],[851],{"id":18,"sortIndex":19,"affiliation":852,"properties":18},{"id":853,"createTime":854,"updateTime":854,"relativeEntities":855,"slug":18,"properties":856,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"f0d89770-5693-4351-ba67-b250c3c6cb39","2023-12-24T03:01:25.423+00:00",[],{"title":857},{"VI":858},"HMC, The Hague, the Netherlands",{"title":860},{"VI":861},"H. M. E. (Jet) van Ufford",{"id":863,"sortIndex":242,"researcher":18,"roles":864,"affiliations":865,"properties":876},"1e577057-7192-492d-b35a-c8e1678bc13a",[424],[866],{"id":18,"sortIndex":19,"affiliation":867,"properties":18},{"id":868,"createTime":869,"updateTime":870,"relativeEntities":871,"slug":872,"properties":873,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"e61d0e0d-b664-4f4b-af4c-e0ccc7280ab4","2024-01-16T19:22:07.169+00:00","2024-11-25T07:53:30.144+00:00",[],"Erasmus-School-of-Health-Policy-and-Management-Erasmus-University-Rotterdam-Rotterdam-The-Netherlands",{"title":874},{"VI":875},"Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands",{"title":877},{"VI":878},"N. (Naomi) van der Linden",{"id":880,"sortIndex":19,"researcher":18,"roles":881,"affiliations":882,"properties":891},"3b687d21-e655-4754-af87-8a5de848d385",[424],[883],{"id":18,"sortIndex":19,"affiliation":884,"properties":18},{"id":885,"createTime":886,"updateTime":886,"relativeEntities":887,"slug":18,"properties":888,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"cd074cd4-8f0d-4201-9fe2-de5d88dd6148","2023-12-24T03:01:25.414+00:00",[],{"title":889},{"VI":890},"Haaglanden Medical Center (HMC), The Hague, the Netherlands",{"title":892},{"VI":893},"M. C. (Christien) van der Linden",{"url":845,"publisher":895,"properties":922},{"id":6,"createTime":7,"updateTime":8,"relativeEntities":896,"slug":10,"properties":897,"entityType":16,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19,"subjectFields":900,"manageAffiliations":901,"indexDatabases":902,"url":18,"thumbnailPath":18,"statistic":917,"gsStatistic":18,"type":18,"analyzePriority":18},[],{"eissn":898,"title":899},{"VOID":13},{"EN":15},[],[],[903,910],{"id":74,"indexDatabase":904,"url":89,"indexYears":18,"academicFieldIds":909,"indexDatabaseRanking":18},{"id":76,"createTime":77,"updateTime":78,"relativeEntities":905,"label":906,"description":907,"key":85,"publicationTags":908,"standard":18},[],{"EN":81,"VI":81},{"VI":83,"EN":84},[87,88],[91],{"id":55,"indexDatabase":911,"url":68,"indexYears":69,"academicFieldIds":916,"indexDatabaseRanking":72},{"id":57,"createTime":58,"updateTime":59,"relativeEntities":912,"label":913,"description":914,"key":65,"publicationTags":915,"standard":18},[],{"EN":62,"VI":62},{"EN":62,"VI":64},[67],[71],{"impactFactor":19,"impactFactorByYear":918,"i10Index":103,"i10IndexLast5Year":40,"totalPublication":104,"totalPublicationByYear":919,"totalCitation":118,"totalCitationByYear":920,"totalCitationPerPublication":133,"totalCitationPerPublicationByYear":921,"hindexLast5Year":150,"hindex":150},{"2012":94,"2013":95,"2014":96,"2015":97,"2016":96,"2017":98,"2018":99,"2019":98,"2020":97,"2021":100,"2022":101,"2023":102},{"2008":106,"2009":107,"2010":108,"2011":109,"2012":110,"2013":111,"2014":107,"2015":112,"2016":113,"2017":114,"2018":115,"2019":116,"2020":112,"2021":117,"2022":103,"2023":106,"2024":111},{"2008":120,"2009":121,"2010":122,"2011":123,"2012":124,"2013":125,"2014":126,"2015":127,"2016":128,"2017":129,"2018":106,"2019":128,"2020":130,"2021":131,"2022":132},{"2008":135,"2009":136,"2010":137,"2011":138,"2012":139,"2013":140,"2014":141,"2015":142,"2016":143,"2017":144,"2018":145,"2019":146,"2020":147,"2021":148,"2022":149},{"volume":923,"pages":925},{"VOID":924},"12",{"VOID":926},"1-11","2019-08-27",2019,{"id":930,"createTime":931,"updateTime":932,"relativeEntities":933,"slug":934,"properties":935,"entityType":176,"verifyStatus":177,"verifyTime":932,"verifyNote":178,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19,"primaryUrl":944,"fullTextUrl":18,"authors":945,"publicationType":203,"publisherRelationship":1006,"citationCount":18,"citationInfo":18,"publishDate":1039,"publishYear":1040,"citationAnalyzeStatus":17,"lastCitationAnalyze":18,"indexDatabases":18,"openAccess":18,"references":18,"isForceReanalyzing":286},"0f81e482-1595-4b67-945a-792a0f868474","2024-01-10T09:46:01.876+00:00","2025-01-02T23:46:52.230+00:00",[],"Backboard-time-for-patients-receiving-spinal-immobilization-by-emergency-medical-services",{"references":936,"abstract":938,"title":940,"doi":942},{"VOID":937},"Ahn H, Singh J, Nathens A, MacDonald RD, Travers A, Tallon J, Fehlings MG, Yee A: Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. J Neurotrauma 2011,28(8):1341–1361. 10.1089\u002Fneu.2009.1168\nVickery D: The use of the spinal board after the pre-hospital phase of trauma management. Emerg Med J 2001,18(1):51–54. 10.1136\u002Femj.18.1.51\nHaut ER, Kalish BT, Efron DT, Haider AH, Stevens KA, Kieninger AN, Cornwell EE 3rd, Chang DC: Spine immobilization in penetrating trauma: more harm than good? J Trauma 2010,68(1):115–120. 10.1097\u002FTA.0b013e3181c9ee58\nHunt K, Hallworth S, Smith M: The effects of rigid collar placement on intracranial and cerebral perfusion pressures. Anaesthesia 2001,56(6):511–513. 10.1046\u002Fj.1365-2044.2001.02053.x\nJohnson DR, Hauswald M, Stockhoff C: Comparison of a vacuum splint device to a rigid backboard for spinal immobilization. Am J Emerg Med 1996,14(4):369–372. 10.1016\u002FS0735-6757(96)90051-0\nLerner EB, Billittier AJ 4th, Moscati RM: The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects. Prehosp Emerg Care 1998,2(2):112–116. 10.1080\u002F10903129808958853\nMarch JA, Ausband SC, Brown LH: Changes in physical examination caused by use of spinal immobilization. Prehosp Emerg Care 2002,6(4):421–424. 10.1080\u002F10903120290938067\nLerner EB, Moscati R: Duration of patient immobilization in the ED. Am J Emerg Med 2000,18(1):28–30. 10.1016\u002FS0735-6757(00)90043-3\nDomeier RM, Evans RW, Swor RA, Rivera-Rivera EJ, Frederiksen SM: Prehospital clinical findings associated with spinal injury. Prehosp Emerg Care 1997,1(1):11–15. 10.1080\u002F10903129708958777\nMuhr MD, Seabrook DL, Wittwer LK: Paramedic use of a spinal injury clearance algorithm reduces spinal immobilization in the out-of-hospital setting. Prehosp Emerg Care 1999,3(1):1–6. 10.1080\u002F10903129908958895\nSahni R, Menegazzi JJ, Mosesso VN Jr: Paramedic evaluation of clinical indicators of cervical spinal injury. Prehosp Emerg Care 1997,1(1):16–18. 10.1080\u002F10903129708958778\nStroh G, Braude D: Can an out-of-hospital cervical spine clearance protocol identify all patients with injuries? An argument for selective immobilization. Ann Emerg Med 2001,37(6):609–615. 10.1067\u002Fmem.2001.114409\nVaillancourt C, Charette M, Kasaboski A, Maloney J, Wells GA, Stiell IG: Evaluation of the safety of C-spine clearance by paramedics: design and methodology. BMC Emerg Med 2011, 11: 1. 10.1186\u002F1471-227X-11-1",{"EN":939},"Use of backboards as part of routine trauma care has recently come into question because of the lack of data to support their effectiveness. Multiple authors have noted the potential harm associated with backboard use, including iatrogenic pain, skin ulceration, increased use of radiographic studies, aspiration and respiratory compromise. An observational study was performed at a level 1 academic trauma center to determine the total and interval backboard times for patients arriving via emergency medical services (EMS). Patients were directly observed. Transport time was recorded as an estimate of initiation of backboard use; arrival time, nurse report time and time of removal from the backboard were all recorded. National Emergency Department Overcrowding Study (NEDOCS) score, Emergency Severity Index (ESI) and demographic information were recorded for each patient encounter. Forty-six patients were followed. The mean total backboard time was 54 min (SD ±65). The mean EMS interval was 33 min (SD ±64), and the mean ED interval was 21 min (SD ±15). The ED backboard interval trended inversely to ESI (1 = 5 min, 2 = 10 min, 3 = 25 min, 4 = 26 min, 5 = 32 min). Patients had a mean total backboard time of around an hour. The mean EMS interval was greater than the mean ED interval. Further study with a larger sample directed to establishing associated factors and to target possible reduction strategies is warranted.",{"EN":941},"Backboard time for patients receiving spinal immobilization by emergency medical services",{"VOID":943},"10.1186\u002F1865-1380-6-17","https:\u002F\u002Fintjem.biomedcentral.com\u002Farticles\u002F10.1186\u002F1865-1380-6-17",[946,961,982,994],{"id":947,"sortIndex":19,"researcher":18,"roles":948,"affiliations":949,"properties":958},"01b393bd-2c1e-416e-9c24-615c0c68fbfa",[424],[950],{"id":18,"sortIndex":19,"affiliation":951,"properties":18},{"id":952,"createTime":953,"updateTime":953,"relativeEntities":954,"slug":18,"properties":955,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"788302c3-03a5-488e-ba2e-b6cf0774117f","2023-12-07T14:55:51.397+00:00",[],{"title":956},{"VI":957},"Department of Emergency Medicine, SUNY Upstate Medical University, EMSTAT 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LC, Baker LS. Excess cost of emergency department visits for nonurgent care. Datawatch. 1994;13(5):162–7.\nJimenez JG, Murray MJ, Beveridge R, Pons JP, Cortes EA, Garrigos JB, Ferre MB. Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in the Principality of Andorra: can triage parameters serve as emergency department quality indicators? CJEM. 2003;5(5):315–22.\nBrentnall EW. A history of triage in civilian hospitals in Australia. Emerg Med. 1997;9:50.\nWengert JW. Jean Dominique Larrey (1766-1842): surgeon of the guard. Mil Med. 1979;144:414–7.\nIserson KV, Moskop JC. Triage in medicine, part I: concept, history, and types. Ann Emerg Med. 2007;49(3):275–81.\nQureshi NA. Triage systems: a review of literature with reference to Saudi Arabia. East Mediterr Health J. 2010;16(6):690–8.\nFarrokhnia N, Castren M, Ehrenberg A, Lind L, Oredsson S, Jonsson H, et al. Emergency department triage scales and their components: a systematic review of the scientific evidence. Scand J Trauma Resusc Emerg Med. 2011;19:42. doi:10.1186\u002F1757-7241-19-42.\nAustralasian College for Emergency Medicine.Guidelines on the implementation of the Australasian triage scale in emergency departments. Available from: https:\u002F\u002Fwww.acem.org.au\u002Fgetattachment\u002Fd19d5ad3-e1f4-4e4f-bf83-7e09cae27d76\u002FG24-Implementation-of-the-Australasian-Triage-Scal.aspx\nMurray M, Bullard M, Grafstein E. Revisions to the Canadian Emergency Department Triage and Acuity Scale implementation guidelines. CJEM. 2004;6(6):421–7.\nWarren DW, Jarvis A, LeBlanc L, Gravel J. Revisions to the Canadian Triage and Acuity Scale paediatricguidelines (PaedCTAS). CJEM. 2008;10(3):224–43.\nElkum NB, Barrett C, Al-Omran H. Canadian Emergency Department Triage and Acuity Scale: implementation in a tertiary care center in Saudi Arabia. BMC Emergency Med. 2011;11:3. doi:10.1186\u002F1471-227X-11-3.\nElkum N, Fahim M, Shoukri M, Al-Madouj A. Which patients wait longer to be seen and when? A waiting time study in the emergency department. East Mediterr Health J. 2009;15(2):416–24.",{"EN":1051},"The objectives of the study is to review and assess the implementation of the applied modified five-level triage and acuity scale triage system in AL-Yarmook Urgent Care Center (UCC), King Abdulaziz Residential City, Riyadh, Saudi Arabia. An observational cross-sectional study was conducted, where a data collection sheet was designed and distributed to triage nurses. The data collection was done during the triage process and was directly observed by the co-investigator. The triage system was reviewed by measuring three time intervals as quality indicators: time before triage (TBT), time before being seen by physician (TBP), and total length of stay (TLS) taking in consideration the timing of presentation and the level of triage. A total of 187 patients visiting the UCC during December 2014 were included. There was an almost equal distribution of males 98 (52 %) and females 89 (48 %) with most of the patients being in the age group of 14 years and younger (n = 85, 46 %). The visits of the patients were classified according to the level of triage from patients to be seen immediately by the physician to those who had been triaged out. Overall, 173 patients (92.5 %) were seen by the physician in a timely manner according to triage guidelines, while 14 patients (7.5 %) were not. The mean time was 5.36 min in TBT, 22.6 min in TBP, and 59 min in TLS. The median time to be seen by the physician was significantly greater (p = 0.001) for the urgent cases on the weekends (25 min; IQR, 21,30) as compared to the weekdays (17 min; IQR, 14,21). Generally, the results did not show significant increases in TBT, TBP, the number of patients not seen at the proper time, or referral and admission rates during weekends. The Canadian Emergency Department Triage and Acuity Scale (CTAS) is adaptable to countries beyond Canada and can be implemented successfully. The applied CTAS triage system in Al-Yarmouk UCC in Riyadh, Saudi Arabia, is considered to be well applied. Overall, urgent cases have been seen by physicians in a timely manner according to the triage system, and there was no delay in the management of critical cases which need prompt attention.",{"EN":1053},"Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in an Urgent Care Center in Saudi 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Arabia",{},{"id":18,"sortIndex":19,"affiliation":1073,"properties":18},{"id":1074,"createTime":1075,"updateTime":1075,"relativeEntities":1076,"slug":18,"properties":1077,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"74cb8675-62ff-42d6-b05f-c2ae6de16a7f","2024-01-09T20:21:21.399+00:00",[],{"title":1078},{"VI":1079},"King Abdulaziz Medical City National Guard, Riyadh, Saudi Arabia",{"title":1081},{"VI":1082},"Ali 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to improve cardiac arrest survival: a time to act. Institute of Medicine (IOM) 2015; citation_publication_date=2015; citation_id=CR1; citation_author=RMM Grahm; citation_author=A Schultz; citation_publisher=National Academies Press\ncitation_journal_title=Prehospital Emergency Care.; citation_title=Emergency medical services information systems and a future EMS national database; citation_author=G Mears, JP Ornato, DE Dawson; citation_volume=6; citation_issue=1; citation_publication_date=2002; citation_pages=12; citation_doi=10.1080\u002F10903120290938931; citation_id=CR2\nNational Highway Traffic and Safety Administration, United States Department of Transportation. Emergency Medical Services performance measures: recommended attributes and indicators for system and services performance Report No.: DOT HS 811 211. \n                  https:\u002F\u002Fwww.ems.gov\u002Fpdf\u002F811211.pdf\n                  \n                . Accessed 13 Dec 2017.\ncitation_journal_title=Prehospital Emerg Care; citation_title=National emergency medical services information system (NEMSIS); citation_author=DE Dawson; citation_volume=10; citation_issue=3; citation_publication_date=2006; citation_pages=314-316; citation_doi=10.1080\u002F10903120600724200; citation_id=CR4\nMann C.,National Emergency Services Information System. Why NEMSIS compliance testing? \n                  https:\u002F\u002Fnemsis.org\u002Fmedia\u002Fbecoming Compliant\u002F documents\u002FWhyNEMSISComplianceTesting.pdf\n                  \n                . Accessed 13 Dec 2017.\nMichigan Department of Health and Human Services. Michigan Emergency Medical Services Information System (MI-EMSIS). \n                  http:\u002F\u002Fwww.michigan.gov\u002Fmdhhs\u002F0,5885,7-339-73970_5093_28508-211272%2D%2D,00.html\n                  \n                . Accessed 13 Dec 2017.\nMonroe County Medical Control Authority. Patient care record electronic documentation & EMS Information System. \n                  http:\u002F\u002Fwww.mercymemorial.org\u002FResource.ashx?sn=sec5PatientCareRecord\n                  \n                . Accessed 6 Dec 2017.\ncitation_journal_title=Ann Emerg Med.; citation_title=EMS agenda for the future: where we are… where we want to be; citation_author=TR Delbridge, B Bailey, JL Chew, AK Conn, JJ Krakeel, D Manz; citation_volume=31; citation_issue=2; citation_publication_date=1998; citation_pages=251-263; citation_doi=10.1016\u002FS0196-0644(98)70316-6; citation_id=CR8\nKuehl A, National Association of EMS Physicians. Prehospital systems and medical oversight: Kendall\u002FHunt Publishing Company; 3rd edition. 2002.\nNational Emergency Medical Services Information System (NEMSIS). Version 3 compliance.\n                  https:\u002F\u002Fnemsis.org\u002Ftechnical-resources\u002Fversion-3\u002Fv3-compliance\u002F\n                  \n                . 2017. Accessed 6 Dec 2017.\nPutnam K. Michigan Department of Health and Human Services. Data collection requirement-MI-EMSIS. \n                  https:\u002F\u002Fwww.michigan.gov\u002Fdocuments\u002Fmdch\u002FData_Collection_Requirement_4542997.pdf\n                  \n                . Accessed 6 Dec 2017.\nImageTrend. ImageTrend EMS Service Bridge. \n                  https:\u002F\u002Fwww.icemapcr.com\u002Fdefault.cfm?page=about\n                  \n                . Accessed 13 Dec 2017.\nLegler J, Rojas Jr J, Jacobson KE, Mann NC. NEMSIS Version 2 to Version 3 translation-user guide. \n                  https:\u002F\u002Fnemsis.org\u002Fmedia\u002Fnemsis_v3\u002Fmaster\u002FTranslation\u002Fv2v3Translation\u002Fv2v3Translation\u002FNEMSIS_V2_V3_Translation_User_Guide.pdf\n                  \n                . Accessed 13 Dec 2017.\nNational Emergency Medical Services Information System. Techincal resources: software developers. \n                  https:\u002F\u002Fnemsis.org\u002Ftechnical-resources\u002F\n                  \n                . Accessed 15 Dec 2017.\nLegler J, Rojas Jr J, Mann, NC. NEMSIS V3 StateDataSet: software developer technical guide. \n                  https:\u002F\u002Fnemsis.org\u002Fmedia\u002Fnemsis_v3\u002Fmaster\u002FUsageGuides\u002FNEMSIS_V3_StateDataSet_Guide.pdf\n                  \n                . Accessed 13 Dec 2017.\nShivley RM. EMS Information System. \n                  http:\u002F\u002Fwww.michigan.gov\u002Fdocuments\u002Fmdhhs\u002FJune_5_2009_Data_Letter_to_MCA_and_LSAs_281985_7_537178_7.pdf\n                  \n                . Accessed 13 Dec 2017.\nTaymour RK, Abir M, Chamberlin M, Dunne RB, Lowell M, Wahl K, et al. Policy, practice, and research agenda for Emergency Medical Services oversight: a systematic review and environmental scan. Prehosp Disaster Med. In Press.\ncitation_journal_title=Prehosp Emerg Care.; citation_title=Performance measurements in Emergency Medical Services; citation_author=J Dunford, RM Domeier, T Blackwell, G Mears, J Overton, EJ Rivera-Rivera, R Swor; citation_volume=6; citation_issue=1; citation_publication_date=2002; citation_pages=92-98; citation_doi=10.1080\u002F10903120290938896; citation_id=CR18\nSchooley B, Horan TA. Emerging digital technologies in Emergency Medical Services: considerations and strategies to strengthen the continuum of care. DOT HS 811 999c. \n                  https:\u002F\u002Fwww.ems.gov\u002Fpdf\u002Fadvancing-ems-systems\u002FReports-and Resources\u002FEmerging Digital TechInEMS.pdf\n                  \n                . Accessed 13 Dec 2017.\nMichigan Department of Health and Human Services. Michigan Statewide Trauma System Lansing. \n                  http:\u002F\u002Fwww.michigan.gov\u002Fmdhhs\u002F0,5885,7-339-71551_69345%2D%2D-,00.html\n                  \n                . Accessed 13 Dec 2017.\ncitation_journal_title=Prehosp Emerg Care.; citation_title=Description of the 2012 NEMSIS public-release research dataset; citation_author=NC Mann, L Kane, M Dai, K Jacobson; citation_volume=19; citation_issue=2; citation_publication_date=2015; citation_pages=232-240; citation_doi=10.3109\u002F10903127.2014.959219; citation_id=CR21\ncitation_title=Base SAS® 9.3 Procedures Guide [computer program]; citation_publication_date=2011; citation_id=CR22; citation_author=SI Inc; citation_publisher=SAS Institute Inc\ncitation_title=Qualitative data analysis: a methods sourcebook; citation_publication_date=2013; citation_id=CR23; citation_author=MB Miles; citation_author=AM Huberman; citation_author=J Saldana; citation_publisher=CA:SAGE Publications\ncitation_journal_title=Ann Fam Med; citation_title=Integrating quantitative and qualitative results in health science mixed methods research through joint displays; citation_author=TC Guetterman, MD Fetters, JW Creswell; citation_volume=13; citation_issue=6; citation_publication_date=2015; citation_pages=554-561; citation_doi=10.1370\u002Fafm.1865; citation_id=CR24\ncitation_journal_title=Aust N Z J Public Health.; citation_title=How can I deal with missing data in my study?; citation_author=DA Bennett; citation_volume=25; citation_issue=5; citation_publication_date=2001; citation_pages=464-469; citation_doi=10.1111\u002Fj.1467-842X.2001.tb00294.x; citation_id=CR25\ncitation_journal_title=Stat Methods Med Res; citation_title=Multiple imputation: a primer; citation_author=JL Schafer; citation_volume=8; citation_issue=1; citation_publication_date=1999; citation_pages=3-15; citation_doi=10.1177\u002F096228029900800102; citation_id=CR26\ncitation_journal_title=Am J Epidemiol; citation_title=Biased estimation of the odds ratio in case-control studies due to the use of ad hoc methods of correcting for missing values for confounding variables; citation_author=W Vach, M Blettner; citation_volume=134; citation_issue=8; citation_publication_date=1991; citation_pages=895-907; citation_doi=10.1093\u002Foxfordjournals.aje.a116164; citation_id=CR27\ncitation_title=Statistical analysis with missing data; citation_publication_date=2002; citation_id=CR28; citation_author=DB Rubin; citation_author=RJ Little; citation_publisher=Wiley\nPutnam, K. Michigan MI-EMSIS PCR Elements V1.1: Michigan required and optional PCR data elements. Lansing, MI.: Michigan Department of Health and Human Services. 2009. \n                  https:\u002F\u002Fwww.michigan.gov\u002Fdocuments\u002Fmdch\u002FMichigan_MI-EMSIS_PCR_Elements_271747_7.pdf\n                  \n                . Accessed 14 Dec 2017.\nNational EMS Database. NEMSIS Reseatch Data Set V2.2.1 and V3.3.4. 2016 user manual. Available at: \n                  https:\u002F\u002Fnemsis.org\u002Fwp-content\u002Fuploads\u002F2017\u002F10\u002FNEMSIS-RDS-221-2016-User-Manual.pdf\n                  \n                . Accessed 5 Dec 2020.\ncitation_journal_title=Disaster Med Public Health Prep; citation_title=Optimizing routine and disaster prehospital care through improved emergency medical services oversight; citation_author=M Abir, J Forman, RK Taymour, C Brent, BK Nallamothu, J Scott, K Wahl; citation_volume=33; citation_issue=1; citation_publication_date=2018; citation_pages=89-97; citation_id=CR31",{"EN":1152},"The study was done to evaluate levels of missing and invalid values in the Michigan (MI) National Emergency Medical Services Information System (NEMSIS) (MI-EMSIS) and explore possible causes to inform improvement in data reporting and prehospital care quality. We used a mixed-methods approach to study trends in data reporting. The proportion of missing or invalid values for 18 key reported variables in the MI-EMSIS (2010–2015) dataset was assessed overall, then stratified by EMS agency, software platform, and Medical Control Authorities (MCA)—regional EMS oversight entities in MI. We also conducted 4 focus groups and 10 key-informant interviews with EMS participants to understand the root causes of data missingness in MI-EMSIS. Only five variables of the 18 studied exhibited less than 10% missingness, and there was apparent variation in the rate of missingness across all stratifying variables under study. No consistent trends over time regarding the levels of missing or invalid values from 2010 to 2015 were identified. Qualitative findings indicated possible causes for this missingness including data-mapping issues, unclear variable definitions, and lack of infrastructure or training for data collection. The adoption of electronic data collection in the prehospital setting can only support quality improvement if its entry is complete. The data suggest that there are many EMS agencies and MCAs with very high levels of missingness, and they do not appear to be improving over time, demonstrating a need for investment in efforts in improving data collection and reporting.",{"EN":1154},"Data missingness in the Michigan NEMSIS (MI-EMSIS) dataset: a mixed-methods 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               \u003Cjats:title>Background\u003C\u002Fjats:title>\n                \u003Cjats:p>During a 6-year period, several process changes were introduced at the emergency department (ED) to decrease crowding, such as the implementation of a general practitioner cooperative (GPC) and additional medical staff during peak hours. In this study, we assessed the effects of these process changes on three crowding measures: patients’ length of stay (LOS), the modified National ED OverCrowding Score (mNEDOCS), and exit block while taking into account changing external circumstances, such as the COVID-19 pandemic and centralization of acute care.\u003C\u002Fjats:p>\n              \u003C\u002Fjats:sec>\u003Cjats:sec>\n                \u003Cjats:title>Methods\u003C\u002Fjats:title>\n                \u003Cjats:p>We determined time points of the various interventions and external circumstances and built an interrupted time-series (ITS) model per outcome measure. We analyzed changes in level and trend before and after the selected time points using ARIMA modeling, to account for autocorrelation in the outcome measures.\u003C\u002Fjats:p>\n              \u003C\u002Fjats:sec>\u003Cjats:sec>\n                \u003Cjats:title>Results\u003C\u002Fjats:title>\n                \u003Cjats:p>Longer patients’ ED LOS was associated with more inpatient admissions and more urgent patients. The mNEDOCS decreased with the integration of the GPC and the expansion of the ED to 34 beds and increased with the closure of a neighboring ED and ICU. More exit blocks occurred when more patients with shortness of breath and more patients > 70 years of age presented to the ED. During the severe influenza wave of 2018–2019, patients’ ED LOS and the number of exit blocks increased.\u003C\u002Fjats:p>\n              \u003C\u002Fjats:sec>\u003Cjats:sec>\n                \u003Cjats:title>Conclusions\u003C\u002Fjats:title>\n                \u003Cjats:p>In the ongoing battle against ED crowding, it is pivotal to understand the effect of interventions, corrected for changing circumstances and patient and visit characteristics. In our ED, interventions which were associated with decreased crowding measures included the expansion of the ED with more beds and the integration of the GPC on the ED.\u003C\u002Fjats:p>\n              \u003C\u002Fjats:sec>",{"EN":1340},"Effects of process changes on emergency department crowding in a changing world: an interrupted time-series analysis",{"VOID":1342},"36792991",{"VOID":1344},"10.1186\u002Fs12245-023-00479-z",[180],"https:\u002F\u002Fintjem.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs12245-023-00479-z",[1348,1366,1380,1396,1416],{"id":1349,"sortIndex":244,"researcher":18,"roles":1350,"affiliations":1351,"properties":1361},"52c0d402-1ff2-4313-bceb-332576e93930",[],[1352],{"id":18,"sortIndex":19,"affiliation":1353,"properties":18},{"id":1354,"createTime":1355,"updateTime":1355,"relativeEntities":1356,"slug":1357,"properties":1358,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"6267e44f-017d-4010-8581-61bc55e88fad","2024-04-14T03:59:37.837+00:00",[],"Department-of-Emergency-Medicine-Haaglanden-Medical-Center-P-O-Box-432-2501-CK-The-Hague-the-Netherlands",{"title":1359},{"EN":1360},"Department of Emergency Medicine, Haaglanden Medical Center, P.O. Box 432, 2501 CK, The Hague, the Netherlands",{"openalex":1362,"title":1364},{"VOID":1363},"A5089582582",{"EN":1365},"Merel van Loon-van Gaalen",{"id":1367,"sortIndex":243,"researcher":18,"roles":1368,"affiliations":1369,"properties":1375},"005f0bbe-8efc-4f8d-9075-4aa5caaa2f8f",[],[1370],{"id":18,"sortIndex":19,"affiliation":1371,"properties":18},{"id":1354,"createTime":1355,"updateTime":1355,"relativeEntities":1372,"slug":1357,"properties":1373,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},[],{"title":1374},{"EN":1360},{"openalex":1376,"title":1378},{"VOID":1377},"A5084692130",{"EN":1379},"Geesje Van Woerden",{"id":1381,"sortIndex":19,"researcher":18,"roles":1382,"affiliations":1383,"properties":1389},"a55d7915-278d-402a-af76-43e8f1acc7dc",[],[1384],{"id":18,"sortIndex":19,"affiliation":1385,"properties":18},{"id":1354,"createTime":1355,"updateTime":1355,"relativeEntities":1386,"slug":1357,"properties":1387,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},[],{"title":1388},{"EN":1360},{"openalex":1390,"orcid":1392,"title":1394},{"VOID":1391},"A5085210860",{"VOID":1393},"https:\u002F\u002Forcid.org\u002F0000-0002-0637-7875",{"EN":1395},"Christien van der Linden",{"id":1397,"sortIndex":481,"researcher":18,"roles":1398,"affiliations":1399,"properties":1409},"7458e94a-e51a-4e82-92e1-e501aa7b945d",[],[1400],{"id":18,"sortIndex":19,"affiliation":1401,"properties":18},{"id":1402,"createTime":1403,"updateTime":1403,"relativeEntities":1404,"slug":1405,"properties":1406,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"515fb444-3c65-4499-bd2e-6a94b562e262","2024-04-14T03:59:37.877+00:00",[],"Department-of-Health-Technology-and-Services-Research-Technical-Medical-Centre-University-of-Twente-P-O-Box-217-7500-AE-Enschede-the-Netherlands",{"title":1407},{"EN":1408},"Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE, Enschede, the Netherlands",{"openalex":1410,"orcid":1412,"title":1414},{"VOID":1411},"A5038392308",{"VOID":1413},"https:\u002F\u002Forcid.org\u002F0000-0003-1646-9834",{"EN":1415},"Naomi van der Linden",{"id":1417,"sortIndex":242,"researcher":18,"roles":1418,"affiliations":1419,"properties":1429},"a5f3f4ac-8987-4021-b92f-d6e3b9be6d2d",[],[1420],{"id":18,"sortIndex":19,"affiliation":1421,"properties":18},{"id":1422,"createTime":1423,"updateTime":1423,"relativeEntities":1424,"slug":1425,"properties":1426,"entityType":39,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19},"5d3858c6-947d-4390-8855-3f317bb53c9f","2024-04-14T03:59:37.850+00:00",[],"Department-of-Emergency-Medicine-University-of-California-Davis-Medical-Center-PSSB-2100-2315-Stockton-Boulevard-Sacramento-CA-95817-USA",{"title":1427},{"EN":1428},"Department of Emergency Medicine, University of California Davis Medical Center, PSSB 2100, 2315 Stockton Boulevard, Sacramento, CA, 95817, USA",{"openalex":1430,"orcid":1432,"title":1434},{"VOID":1431},"A5082062213",{"VOID":1433},"https:\u002F\u002Forcid.org\u002F0000-0003-1251-3877",{"EN":1435},"John R. Richards",{"url":18,"publisher":1437,"properties":18},{"id":6,"createTime":7,"updateTime":8,"relativeEntities":1438,"slug":10,"properties":1439,"entityType":16,"verifyStatus":17,"verifyTime":18,"verifyNote":18,"syncStatus":17,"languages":18,"translateLanguages":18,"viewCount":19,"subjectFields":1442,"manageAffiliations":1443,"indexDatabases":1444,"url":18,"thumbnailPath":18,"statistic":1459,"gsStatistic":18,"type":18,"analyzePriority":18},[],{"eissn":1440,"title":1441},{"VOID":13},{"EN":15},[],[],[1445,1452],{"id":74,"indexDatabase":1446,"url":89,"indexYears":18,"academicFieldIds":1451,"indexDatabaseRanking":18},{"id":76,"createTime":77,"updateTime":78,"relativeEntities":1447,"label":1448,"description":1449,"key":85,"publicationTags":1450,"standard":18},[],{"EN":81,"VI":81},{"VI":83,"EN":84},[87,88],[91],{"id":55,"indexDatabase":1453,"url":68,"indexYears":69,"academicFieldIds":1458,"indexDatabaseRanking":72},{"id":57,"createTime":58,"updateTime":59,"relativeEntities":1454,"label":1455,"description":1456,"key":65,"publicationTags":1457,"standard":18},[],{"EN":62,"VI":62},{"EN":62,"VI":64},[67],[71],{"impactFactor":19,"impactFactorByYear":1460,"i10Index":103,"i10IndexLast5Year":40,"totalPublication":104,"totalPublicationByYear":1461,"totalCitation":118,"totalCitationByYear":1462,"totalCitationPerPublication":133,"totalCitationPerPublicationByYear":1463,"hindexLast5Year":150,"hindex":150},{"2012":94,"2013":95,"2014":96,"2015":97,"2016":96,"2017":98,"2018":99,"2019":98,"2020":97,"2021":100,"2022":101,"2023":102},{"2008":106,"2009":107,"2010":108,"2011":109,"2012":110,"2013":111,"2014":107,"2015":112,"2016":113,"2017":114,"2018":115,"2019":116,"2020":112,"2021":117,"2022":103,"2023":106,"2024":111},{"2008":120,"2009":121,"2010":122,"2011":123,"2012":124,"2013":125,"2014":126,"2015":127,"2016":128,"2017":129,"2018":106,"2019":128,"2020":130,"2021":131,"2022":132},{"2008":135,"2009":136,"2010":137,"2011":138,"2012":139,"2013":140,"2014":141,"2015":142,"2016":143,"2017":144,"2018":145,"2019":146,"2020":147,"2021":148,"2022":149},{"total":19,"publishYear":18,"statisticByYear":1465},{},[1467,1471,1475,1479,1483,1486,1490,1494,1498,1502,1506,1509,1513,1517,1521,1525,1528,1532,1536,1540,1543,1547,1551,1555,1559,1563,1567,1571,1575,1578,1582,1586,1590,1593,1597,1601,1605,1609],{"id":18,"text":1468,"url":18,"identifiers":1469},"Pines JM, Hilton JA, Weber EJ, Alkemade AJ, Al Shabanah H, Anderson PD, et al. International perspectives on emergency department crowding. Acad Emer Med. 2011;18(12):1358–70.",{"doi":1470},"10.1111\u002Fj.1553-2712.2011.01235.x",{"id":18,"text":1472,"url":18,"identifiers":1473},"McKenna PH, Samita M, Viccellio P, Mallon WK, Hernandez C, Morley EJ. Emergency department and hospital crowding: causes, consequences, and cures. Clin Exp Emerg Med. 2019;6(3):189.",{"doi":1474},"10.15441\u002Fceem.18.022",{"id":18,"text":1476,"url":18,"identifiers":1477},"Carter EJ, Pouch SM, Larson EL. The relationship between emergency department crowding and patient outcomes: a systematic review. J Nursing Scholar. 2014;46(2):106–15.",{"doi":1478},"10.1111\u002Fjnu.12055",{"id":18,"text":1480,"url":18,"identifiers":1481},"Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: a systematic review of causes, consequences and solutions. PloS One. 2018;13(8):e0203316.",{"doi":1482},"10.1371\u002Fjournal.pone.0203316",{"id":18,"text":1484,"url":18,"identifiers":1485},"Javidan AP, Hansen K, Higginson I, Jones P, Petrie D, Bonning J, et al. Report from the Emergency Department Crowding and Access Block Task Force [Internet]. International Federation for Emergency Medicine; 2020. Available from: https:\u002F\u002Fwww.ifem.cc\u002Fresource-library\u002F.",{},{"id":18,"text":1487,"url":18,"identifiers":1488},"Jones PG, Mountain D, Forero R. Emergency department crowding measures associations with quality of care: a systematic review. Emerg Med Aust. 2021;33(4):592–600.",{"doi":1489},"10.1111\u002F1742-6723.13743",{"id":18,"text":1491,"url":18,"identifiers":1492},"Ye L, Zhou G, He X, Shen W, Gan J, Zhang M. Prolonged length of stay in the emergency department in high-acuity patients at a Chinese tertiary hospital. Emerg Med Aust. 2012;24(6):634–40.",{"doi":1493},"10.1111\u002Fj.1742-6723.2012.01588.x",{"id":18,"text":1495,"url":18,"identifiers":1496},"McCarthy ML, Zeger SL, Ding R, Levin SR, Desmond JS, Lee J, et al. Crowding delays treatment and lengthens emergency department length of stay, even among high-acuity patients. Annals Emerg Med. 2009;54(4):492–503.",{"doi":1497},"10.1016\u002Fj.annemergmed.2009.03.006",{"id":18,"text":1499,"url":18,"identifiers":1500},"Joseph JW, White BA. Emergency department operations: an overview. Emerg Med Clin. 2020;38(3):549–62.",{"doi":1501},"10.1016\u002Fj.emc.2020.04.005",{"id":18,"text":1503,"url":18,"identifiers":1504},"Knowles E, Mason SM, Smith C. Factors associated with exit block and impact on the emergency department. Emerg Med J. 2017;34(1):61–2.",{"doi":1505},"10.1136\u002Femermed-2015-205202",{"id":18,"text":1507,"url":18,"identifiers":1508},"Mackway-Jones K, Marsden J, Windle J. Emergency triage: Manchester triage group: John Wiley & Sons; 2014.",{},{"id":18,"text":1510,"url":18,"identifiers":1511},"van der Linden MC, de Beaufort RA, Meylaerts SA, van den Brand CL, van der Linden N. The impact of medical specialist staffing on emergency department patient flow and satisfaction. Eu J Emer Med. 2019;26(1):47–52.",{"doi":1512},"10.1097\u002FMEJ.0000000000000487",{"id":18,"text":1514,"url":18,"identifiers":1515},"van der Linden MC, van den Brand CL, van den Wijngaard IR, de Beaufort RA, van der Linden N, Jellema K. A dedicated neurologist at the emergency department during out-of-office hours decreases patients’ length of stay and admission percentages. J Neurol. 2018;265(3):535–41.",{"doi":1516},"10.1007\u002Fs00415-018-8734-x",{"id":18,"text":1518,"url":18,"identifiers":1519},"Van Der Linden MC, Balk FJ, Van Der Hoeven BJ, Van Loon M, De Voeght FJ, Van Der Linden N. Emergency department care for patients with mental health problems, a longitudinal registry study and a before and after intervention study. Int Emerg Nurs. 2019;44:14–9.",{"doi":1520},"10.1016\u002Fj.ienj.2019.02.003",{"id":18,"text":1522,"url":18,"identifiers":1523},"De Kok BM, Eijlers B, Van Der Linden MC, Quarles-Van Ufford HME. Lean-driven interventions, including a dedicated radiologist, improve diagnostic imaging turnaround time and radiology report time at the emergency department. Emerg Radiol. 2020;28(1):23–9.",{"doi":1524},"10.1007\u002Fs10140-020-01803-3",{"id":18,"text":1526,"url":18,"identifiers":1527},"Van Der Linden MC, Quarles van Ufford HM, Project Group Medical Specialists, Van Der Linden N. The impact of a multimodal intervention on emergency department crowding and patient flow. International. J Emerg Med. 2019;12(1):21.",{},{"id":18,"text":1529,"url":18,"identifiers":1530},"Van Veelen MJ, Van Den Brand CL, Reijnen R, Van Der Linden MC. Effects of a general practitioner cooperative co-located with an emergency department on patient throughput. W J Emerg Med. 2016;7(4):270.",{"doi":1531},"10.5847\u002Fwjem.j.1920-8642.2016.04.005",{"id":18,"text":1533,"url":18,"identifiers":1534},"Schanzer DL, Schwartz B. Impact of seasonal and pandemic influenza on emergency department visits, 2003–2010, Ontario. Canada. Acad Emerg Med. 2013;20(4):388–97.",{"doi":1535},"10.1111\u002Facem.12111",{"id":18,"text":1537,"url":18,"identifiers":1538},"Schull MJ, Mamdani MM, Fang J. Influenza and emergency department utilization by elders. Acad Emerg Med. 2005;12(4):338–44.",{"doi":1539},"10.1197\u002Fj.aem.2004.11.020",{"id":18,"text":1541,"url":18,"identifiers":1542},"Dutch Centre for Infection Disease Control. Feiten en cijfers griep in Nederland [In Dutch]: www.rivm.nl; 2019-2020 [Available from: https:\u002F\u002Fwww.rivm.nl\u002Fdocumenten\u002Ffeiten-en-cijfers-griep-winter-2019-2020.",{},{"id":18,"text":1544,"url":18,"identifiers":1545},"Weiss SJ, Derlet R, Arndahl J, Ernst AA, Richards J, Fernández-Frankelton M, et al. Estimating the degree of emergency department overcrowding in academic medical centers: results of the National ED Overcrowding Study (NEDOCS). Acad Emerg Med. 2004;11(1):38–50.",{"doi":1546},"10.1111\u002Fj.1553-2712.2004.tb01369.x",{"id":18,"text":1548,"url":18,"identifiers":1549},"Van Der Linden MC, Van Loon M, Gaakeer MI, Richards JR, Derlet RW, Van Der Linden N. A different crowd, a different crowding level? The predefined thresholds of crowding scales may not be optimal for all emergency departments. Int Emerg Nurs. 2018;41:25–30.",{"doi":1550},"10.1016\u002Fj.ienj.2018.05.004",{"id":18,"text":1552,"url":18,"identifiers":1553},"Van Der Linden MC, Reijnen R, Derlet RW, Lindeboom R, Van Der Linden N, Lucas C, et al. Emergency department crowding in The Netherlands: managers’ experiences. Int J Emerg Med. 2013;6(1):41.",{"doi":1554},"10.1186\u002F1865-1380-6-41",{"id":18,"text":1556,"url":18,"identifiers":1557},"Lee SR, Do Shin S, Ro YS, Lee H, Yoon JY. Multimodal quality improvement intervention with dedicated patient flow manager to reduce emergency department length of stay and occupancy: interrupted time series analysis. J Emerg Nurs. 2022;48(2):211.",{"doi":1558},"10.1016\u002Fj.jen.2021.12.001",{"id":18,"text":1560,"url":18,"identifiers":1561},"Salway R, Valenzuela R, Shoenberger J, Mallon W, Viccellio A. Emergency department (ED) overcrowding: evidence-based answers to frequently asked questions. Revista Médica Clínica Las Condes. 2017;28(2):213–9.",{"doi":1562},"10.1016\u002Fj.rmclc.2017.04.008",{"id":18,"text":1564,"url":18,"identifiers":1565},"Sivey P, McAllister R, Vally H, Burgess A, Kelly A-M. Anatomy of a demand shock: quantitative analysis of crowding in hospital emergency departments in Victoria, Australia during the 2009 influenza pandemic. PloS One. 2019;14(9).",{"doi":1566},"10.1371\u002Fjournal.pone.0222851",{"id":18,"text":1568,"url":18,"identifiers":1569},"Ramlakhan S, Mason S, O'Keeffe C, Ramtahal A, Ablard S. Primary care services located with EDs: a review of effectiveness. Emerg Med J. 2016;33(7):495–503.",{"doi":1570},"10.1136\u002Femermed-2015-204900",{"id":18,"text":1572,"url":18,"identifiers":1573},"Mumma BE, McCue JY, Li CS, Holmes JF. Effects of emergency department expansion on emergency department patient flow. 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