A Scoping Review of Emergency Department Discharge Risk Stratification

Introduction: Although emergency department (ED) discharge presents patient-safety challenges and opportunities, the ways in which EDs address discharge risk in the general ED population remains disparate and largely uncharacterized. In this study our goal was to conduct a review of how EDs identify...

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Autores principales:	Todd A. Jaffe, Daniel Wang, Bosten Loveless, Debbie Lai, Michael Loesche, Benjamin White, Ali S. Raja, Shuhan He
Formato:	article
Lenguaje:	EN
Publicado:	eScholarship Publishing, University of California 2021
Materias:	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/88b256e743674f9aa2af60a0567a104c
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spelling	oai:doaj.org-article:88b256e743674f9aa2af60a0567a104c2021-11-17T15:19:27ZA Scoping Review of Emergency Department Discharge Risk Stratification1936-901810.5811/westjem.2021.6.52969https://doaj.org/article/88b256e743674f9aa2af60a0567a104c2021-09-01T00:00:00Zhttps://escholarship.org/uc/item/33w8n8mbhttps://doaj.org/toc/1936-9018Introduction: Although emergency department (ED) discharge presents patient-safety challenges and opportunities, the ways in which EDs address discharge risk in the general ED population remains disparate and largely uncharacterized. In this study our goal was to conduct a review of how EDs identify and target patients at increased risk at time of discharge. Methods: We conducted a literature search to explore how EDs assess patient risk upon discharge, including a review of PubMed and gray literature. After independently screening articles for inclusion, we recorded study characteristics including outcome measures, patient risk factors, and tool descriptions. Based on this review and discussion among collaborators, major themes were identified. Results: PubMed search yielded 384 potentially eligible articles. After title and abstract review, we screened 235 for potential inclusion. After full text and reference review, supplemented by Google Scholar and gray literature reviews, we included 30 articles for full review. Three major themes were elucidated: 1) Multiple studies include retrospective risk assessment, whereas the use of point-of-care risk assessment tools appears limited; 2) of the point-of-care tools that exist, inputs and outcome measures varied, and few were applicable to the general ED population; and 3) while many studies describe initiatives to improve the discharge process, few describe assessment of post-discharge resource needs. Conclusion: Numerous studies describe factors associated with an increased risk of readmission and adverse events after ED discharge, but few describe point-of-care tools used by physicians for the general ED population. Future work is needed to investigate standardized tools that assess ED discharge risk and patients’ needs upon ED discharge.Todd A. JaffeDaniel WangBosten LovelessDebbie LaiMichael LoescheBenjamin WhiteAli S. RajaShuhan HeeScholarship Publishing, University of CaliforniaarticleMedicineRMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENWestern Journal of Emergency Medicine, Vol 22, Iss 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Todd A. Jaffe Daniel Wang Bosten Loveless Debbie Lai Michael Loesche Benjamin White Ali S. Raja Shuhan He A Scoping Review of Emergency Department Discharge Risk Stratification
description	Introduction: Although emergency department (ED) discharge presents patient-safety challenges and opportunities, the ways in which EDs address discharge risk in the general ED population remains disparate and largely uncharacterized. In this study our goal was to conduct a review of how EDs identify and target patients at increased risk at time of discharge. Methods: We conducted a literature search to explore how EDs assess patient risk upon discharge, including a review of PubMed and gray literature. After independently screening articles for inclusion, we recorded study characteristics including outcome measures, patient risk factors, and tool descriptions. Based on this review and discussion among collaborators, major themes were identified. Results: PubMed search yielded 384 potentially eligible articles. After title and abstract review, we screened 235 for potential inclusion. After full text and reference review, supplemented by Google Scholar and gray literature reviews, we included 30 articles for full review. Three major themes were elucidated: 1) Multiple studies include retrospective risk assessment, whereas the use of point-of-care risk assessment tools appears limited; 2) of the point-of-care tools that exist, inputs and outcome measures varied, and few were applicable to the general ED population; and 3) while many studies describe initiatives to improve the discharge process, few describe assessment of post-discharge resource needs. Conclusion: Numerous studies describe factors associated with an increased risk of readmission and adverse events after ED discharge, but few describe point-of-care tools used by physicians for the general ED population. Future work is needed to investigate standardized tools that assess ED discharge risk and patients’ needs upon ED discharge.
format	article
author	Todd A. Jaffe Daniel Wang Bosten Loveless Debbie Lai Michael Loesche Benjamin White Ali S. Raja Shuhan He
author_facet	Todd A. Jaffe Daniel Wang Bosten Loveless Debbie Lai Michael Loesche Benjamin White Ali S. Raja Shuhan He
author_sort	Todd A. Jaffe
title	A Scoping Review of Emergency Department Discharge Risk Stratification
title_short	A Scoping Review of Emergency Department Discharge Risk Stratification
title_full	A Scoping Review of Emergency Department Discharge Risk Stratification
title_fullStr	A Scoping Review of Emergency Department Discharge Risk Stratification
title_full_unstemmed	A Scoping Review of Emergency Department Discharge Risk Stratification
title_sort	scoping review of emergency department discharge risk stratification
publisher	eScholarship Publishing, University of California
publishDate	2021
url	https://doaj.org/article/88b256e743674f9aa2af60a0567a104c
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A Scoping Review of Emergency Department Discharge Risk Stratification

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