Search

Your search keyword '"Michael Bullard"' showing total 40 results
Start Over Author "Michael Bullard"
40 results on '"Michael Bullard"'

1. Consistency of triage scores by presenting complaint pre‐ and post‐implementation of a real‐time electronic triage decision support tool

Author

Shelley L. McLeod, Cameron Thompson, Bjug Borgundvaag, Lehana Thabane, Howard Ovens, Steve Scott, Tamer Ahmed, Keerat Grewal, Joy McCarron, Brooke Filsinger, Nicole Mittmann, Andrew Worster, Thomas Agoritsas, Michael Bullard, and Gordon Guyatt

Subjects
consistency, eCTAS, modifiers, triage, variability, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Objective eCTAS is a real‐time electronic decision‐support tool designed to standardize the application of the Canadian Triage and Acuity Scale (CTAS). This study addresses the variability of CTAS score distributions across institutions pre‐ and post‐eCTAS implementation. Methods We used population‐based administrative data from 2016–2018 from all emergency departments (EDs) that had implemented eCTAS for 9 months. Following a 3‐month stabilization period, we compared 6 months post‐eCTAS data to the same 6 months the previous year (pre‐eCTAS). We included triage encounters of adult (≥17 years) patients who presented with 1 of 16 pre‐specified, high‐volume complaints. For each ED, consistency was calculated as the absolute difference in CTAS distribution compared to the average of all included EDs for each presenting complaint. Pre‐eCTAS and post‐eCTAS change scores were compared using a paired‐samples t‐test. We also assessed if eCTAS modifiers were associated with triage consistency. Results There were 363,214 (183,231 pre‐eCTAS, 179,983 post‐eCTAS) triage encounters included from 35 EDs. Triage scores were more consistent (P

Published
2020
Full Text
View/download PDF

2. Increasing the Use of Anti-Inflammatory Agents for Acute Asthma in the Emergency Department: Experience with an Asthma Care Map

Author

Brian H Rowe, Anthony M Chahal, Carol H Spooner, Sandra Blitz, Ambikaipakan Senthilselvan, Deborah Wilson, Brian R Holroyd, and Michael Bullard

Subjects
Diseases of the respiratory system, RC705-779
Abstract

PURPOSE: Acute asthma is a common emergency department (ED) presentation and variation in its management is well recognized. The present study examined the use of an asthma care map (ACM) in one Canadian ED to improve adherence to acute asthma guidelines, emphasizing the use of systemic corticosteroids (SCSs) and inhaled corticosteroids (ICSs).

Published
2008
Full Text
View/download PDF

35. The role of triage liaison physicians on mitigating overcrowding in emergency departments: a systematic review

Author

Brian H, Rowe, Xiaoyan, Guo, Cristina, Villa-Roel, Michael, Schull, Brian, Holroyd, Michael, Bullard, Benjamin, Vandermeer, Maria, Ospina, and Grant, Innes

Subjects
Crowding, Meta-Analysis as Topic, Physicians, Emergency Medicine, Humans, Length of Stay, Triage, Emergency Service, Hospital, Randomized Controlled Trials as Topic
Abstract

The objective was to examine the effectiveness of triage liaison physicians (TLPs) on mitigating the effects of emergency department (ED) overcrowding.Electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Web of Science, HealthSTAR, Dissertation Abstracts, and ABI/INFORM Global), controlled trial registry websites, conference proceedings, study references, contact with experts in the field, and correspondence with authors were used to identify potentially relevant TLP studies. Intervention studies in which a TLP was used to influence ED overcrowding metrics (length of stay [LOS] in minutes, physician initial assessment [PIA], and left without being seen [LWBS]) were included in the review. Two reviewers independently conducted data extraction and assessed the citation relevance, inclusion, and study quality. For continuous outcomes, weighted mean differences (WMD) were calculated and reported with corresponding 95% confidence intervals (CIs). For dichotomous variables, individual and pooled statistics were calculated as relative risk (RR) with 95% CI.From 14,446 potentially relevant studies, 28 were included in the systematic review. Thirteen were journal publications, 12 were abstracts, and three were Web-based articles. Most studies employed before-after designs; 23 of the 28 studies were considered of weak quality. Based on the statistical pooling of data from two randomized controlled trials (RCTs), TLP resulted in shorter ED LOS compared to nurse-led triage (WMD = -36.85 min; 95% CI = -51.11 to -22.58). One of these RCTs showed a significant reduction in the PIA associated to TLP presence (WMD = -30.00 min; 95% CI = -56.91 to -3.09); the other RCT showed no change in LWBS due to a CI that included unity (RR = 0.82; 95% CI = 0.67 to 1.00).While the evidence summarized here suggests that to have a TLP is an effective intervention to mitigate the effects of ED overcrowding, due to the weak research methods identified, more research is required before its widespread implementation.

Published
2011

40. Introduction

Author

Michael Bullard and David Rhine

Subjects
Emergency Medicine
Abstract

Our CJEM Journal Club consists of two sections. The first, “Critically Appraised Topics,” is devoted to evidence-based reviews of specific EM-related questions. Questions will be answered by using a focused literature review and presenting the results in a CAT (Critically Appraised Topic) format. The aims of this section are to address clinical or administrative questions, to demonstrate the application of evidence-based medicine methods in answering such questions, and to accumulate a CAT database for emergency physicians.

Published
1999
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results