Jennifer L. Wiler

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As administrators evaluate potential approaches to improve cost, quality, and throughput efficiencies in the emergency department (ED), "front-end" operations become an important area of focus. Interventions such as immediate bedding, bedside registration, advanced triage (triage-based care) protocols, physician/practitioner at triage, dedicated "fast(More)
Tuberculosis (TB) is the world's leading infectious disease killer after AIDS [Tubercle. 1991;72:1-6; Lancet. 2003;362(9387):887-899]. Vertebral TB is the most common form of skeletal TB [Spine. 1997; 22(15):1791-1797], whereas male genital TB is an uncommon form of extrapulmonary TB [Urol Clin North Am. 2003;30(1):111-121]. We present the case of a man who(More)
BACKGROUND Ultrasound is a useful adjunct to many Emergency Department (ED) procedures. Arthrocentesis is typically performed using a landmark technique but ultrasound may provide an opportunity to improve arthrocentesis performance. OBJECTIVE To assess the success of emergency physicians performing landmark (LM) vs. ultrasound (US)-guided knee(More)
Emergency department (ED) crowding is an international phenomenon that continues to challenge operational efficiency. Many statistical modeling approaches have been offered to describe, and at times predict, ED patient load and crowding. A number of formula-based equations, regression models, time-series analyses, queuing theory-based models, and(More)
With passage of the Patient Protection and Affordable Care Act of 2010, payment incentives were created to improve the "value" of health care delivery. Because physicians and physician practices aim to deliver care that is both clinically effective and patient centered, it is important to understand the association between the patient experience and quality(More)
INTRODUCTION Reducing non-urgent emergency department (ED) visits has been targeted as a method to produce cost savings. To better describe these visits, we sought to compare resource utilization of ED visits characterized as non-urgent at triage to immediate, emergent, or urgent (IEU) visits. METHODS We performed a retrospective, cross-sectional analysis(More)
OBJECTIVES All services provided by physicians to patients during an emergency department (ED) visit, including procedures and "cognitive work," are described by common procedural terminology (CPT) codes that are translated by coders into total professional (physician) charges for the visit. These charges do not include the technical (facility) charges. The(More)
STUDY OBJECTIVE We compare the association between barriers to timely primary care and emergency department (ED) utilization among adults with Medicaid versus private insurance. METHODS We analyzed 230,258 adult participants of the 1999 to 2009 National Health Interview Survey. We evaluated the association between 5 specific barriers to timely primary(More)
OBJECTIVES The objective was to describe patient and facility characteristics of emergency department (ED) observation services in the United States. METHODS The authors analyzed the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS). Characteristics of EDs with observation units (OUs) were compared to those without, and patients with a(More)