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Biomedical subjects

Alan E O'Connor

Publications and source records attributed to Alan E O'Connor.

7 recordsLinked to original sources
PubMed2004

Does the presence of an emergency physician improve access based quality indicators in a rural emergency department?

OBJECTIVE: To assess the effect that the presence of an emergency physician in the ED has on the access indicators of the Australian Council on Healthcare Standards. METHODS: A retrospective study was carried out in a 265 bed regional referral hospital in Victoria. The performance of the ED over a 6 month period, during which time there was incomplete emergency physician coverage, was monitored using The Australian Council on Healthcare Standards (ACHS) access indicators as the benchmark. These indicators are waiting time by triage category, and access block. RESULTS: A total of 11 999 patient presentations were eligible for inclusion in the study. Emergency physicians were present for 76.5% of these presentations. All the indicators show a trend towards improvement when an emergency physician was present. However, the only indicator that shows a significant improvement is waiting time by triage category, and this is due mainly to an improvement within triage category 4. CONCLUSIONS: There is some evidence that the presence of an emergency physician improves performance within this group of access based indicators within a rural ED, however, the effect seen here is small. More studies are needed on this topic and also on the development of quality indicators for rural ED.

Emergency Service, Hospital↗
PubMed2002

A review of the accuracy of references in the journal Emergency Medicine.

OBJECTIVE: To assess the accuracy of references in articles published in Emergency Medicine, and to categorize these errors. METHODS: All the references in Volume 12 of Emergency Medicine were listed and numbered consecutively. A sample of 100 references was then selected. Each reference was then checked, initially on an electronic database, with the original article being used as the gold standard. RESULTS: 1469 citations were included in the study. A random sample of 100 was taken and examined in detail. 35 papers were shown to have at least one error, and a total of 41 errors were found. The maximum number of errors in one paper was 3. These errors are analysed in detail. CONCLUSION: Poor reference accuracy is a common problem in medical literature, and Emergency Medicine is not immune to these failings. Authors need to take more care to ensure that the accuracy of citations improves.

Bibliographies as Topic↗
PubMed2002

A comparison of the antemortem clinical diagnosis and autopsy findings for patients who die in the emergency department.

OBJECTIVES: In spite of advances in medical technology, there remains a high discrepancy rate between the antemortem clinical diagnosis and postmortem examination diagnosis for patients who die in hospitals. The aim of this study was to compare the clinical and postmortem examination diagnoses of patients who died in the emergency department (ED) of a tertiary hospital, and to analyze any discrepancy between them. METHODS: The study was a retrospective chart review of patients who died in the ED of a tertiary referral teaching hospital and a comparison of the antemortem diagnosis with the autopsy diagnosis. Any missed diagnosis was classified, according to the Goldman criteria, into major and minor missed diagnoses. RESULTS: A total of 59 patients were eligible for inclusion in the study. There was complete agreement between the antemortem diagnosis and the autopsy result in 51% of cases. The incidence of major missed diagnoses-where if the diagnosis had been known before the patient died, treatment may have been altered or survival may have been prolonged-was 7%. CONCLUSIONS: There is a significant discrepancy rate between the antemortem diagnosis and the autopsy diagnosis. However, in this study, serious missed diagnoses in which outcome may have been significantly altered are unusual among those who die in the ED of a tertiary referral hospital.

Australian Capital Territory↗