Browsing by Author "Major, Daniel"

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    Addictions and Mental Health Patient Boarding in Emergency Departments: Protocol for a Scoping Review
    (2023-06-08) Ridout, Amelia; Antonio, Anjolaoluwa; Bolton, James; Chan, Eric; Chisholm, Cassandra; Chow, Kristian; Ganshorn, Heather; Grimminck, Rachel; Major, Daniel; Nordstrom, Kimberly; Pearlmutter, Mark; Lang, Eddy
    Objective: The objective of this scoping review is to understand the extent, nature, and quality of evidence relating to the boarding of addictions and mental health (AMH) patients in emergency departments (EDs). Introduction: ‘Boarding’ refers to the time a patient spends in the ED before being transferred to an inpatient bed after an admission decision has been made (1-4). AMH patients are disproportionately likely to experience boarding (1,4,5). Patients can be boarded in the ED for many hours or days, often under suboptimal conditions that harm their health and wellbeing (6). Despite the ongoing issue of AMH patient boarding in EDs across Canada and globally, there is a lack of scoping or systematic reviews that synthesize the literature on this topic. Inclusion criteria: This scoping review will include peer-reviewed literature of all study designs and methodologies that meets the following inclusion criteria: (1) involve a participant population of pediatric and/or adult patients with substance use and/or mental health disorders, (2) focus on the concept of boarding or delayed transfer, and (3) occur within the context of a hospital ED. Methods: We will search the following electronic databases: MEDLINE, Embase, PsycINFO (on the Ovid platform), and CINAHL (on the Ebsco platform). Covidence software will be used to manage the results of the search, select studies that meet the inclusion criteria, remove duplicates, and extract data. Studies will be critically appraised using JBI critical appraisal checklists (7). Results will be reported in accordance with the PRISMA-ScR checklist (8).
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    Exploring the experience of boarded psychiatric patients in adult emergency departments
    (2021-09-27) Major, Daniel; Rittenbach, Katherine; MacMaster, Frank; Walia, Hina; VandenBerg, Stephanie D.
    Abstract Background This study quantifies the frequency of adverse events (AEs) experienced by psychiatric patients while boarded in the emergency department (ED) and describes those events over a broad range of categories. Methods A retrospective chart review (RCR) of adult psychiatric patients aged 18–55 presenting to one of four Calgary EDs (Foothills Medical Centre (FMC), the Peter Lougheed Centre (PLC), the Rockyview General Hospital (RGH), and South Health Campus (SHC)) who were subsequently admitted to an inpatient psychiatric unit between January 1, 2019 and May 15, 2019 were eligible for review. A test of association was used to determine the odds of an independent variable being associated with an adverse event. Results During the study time period, 1862 adult patients were admitted from EDs (city wide) to the psychiatry service. Of the 200 charts reviewed, the average boarding time was 23.5 h with an average total ED length of stay of 31 h for all presentations within the sample. Those who experienced an AE while boarded in the ED had a significantly prolonged average boarding time (35 h) compared to those who did not experience one (6.5 h) (p = 0.005). Conclusions The length of time a patient is in the emergency department and the length of time a patient is boarded after admission significantly increases the odds that the patient will experience an AE while in the ED. Other significant factors associated with AEs include the type of admission and the hospital the patient was admitted from.