Brent R Asplin

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Emergency department (ED) crowding has become a major barrier to receiving timely emergency care in the United States. Despite widespread recognition of the problem, the research and policy agendas needed to understand and address ED crowding are just beginning to unfold. We present a conceptual model of ED crowding to help researchers, administrators, and(More)
BACKGROUND An Institute of Medicine (IOM) report defines six domains of quality of care: safety, patient-centeredness, timeliness, efficiency, effectiveness, and equity. The effect of emergency department (ED) crowding on these domains of quality has not been comprehensively evaluated. OBJECTIVES The objective was to review the medical literature(More)
CONTEXT There is growing pressure to avoid hospitalizing emergency department patients who can be treated safely as outpatients, but this strategy depends on timely access to follow-up care. OBJECTIVE To determine the association between reported insurance status and access to follow-up appointments for serious conditions that are commonly identified(More)
Frequent use of emergency department (ED) services is often perceived to be a potentially preventable misuse of resources. The underlying assumption is that similar and more appropriate care can be delivered outside of EDs at a lower cost. To reduce costs and incentivize more appropriate use of services, there have been efforts to design interventions to(More)
A primary goal of the Academic Emergency Medicine Consensus Conference, "The Unraveling Safety Net: Research Opportunities and Priorities," was to explore a formal research agenda for safety net research in emergency medicine. This paper represents the thoughts of active health services researchers regarding the structure and direction of such work,(More)
There is a growing mandate from the public, payers, hospitals, and Centers for Medicare & Medicaid Services (CMS) to measure and improve emergency department (ED) performance. This creates a compelling need for a standard set of definitions about the measurement of ED operational performance. This Concepts article reports the consensus of a summit of(More)
Every emergency physician in the United States and, for that matter, in many countries around the world recognizes that the demand for timely access to quality emergency care is one that patients highly value. Unfortunately, hospitals in the USA have become stretched beyond capacity, resulting in overloaded emergency departments, diverted ambulances, and(More)
Between 1993 and 2003, visits to U.S. emergency departments (EDs) increased by 26%, to a total of 114 million visits annually. At the same time, the number of U.S. EDs decreased by more than 400, and almost 200,000 inpatient hospital beds were taken out of service. In this context, the adequacy of daily surge capacity within the system is clearly an(More)
STUDY OBJECTIVE To assess the prognostic value of initial end-tidal CO2 pressures (PETCO2) during CPR in patients with out-of-hospital cardiac arrest (OHCA). DESIGN A prospective observational study using a convenience sample. SETTING Primary service area of an advanced life support (ALS) ambulance service, including a city with a population of 70,745(More)