Emergency department medication dispensing reduces return visits and admissions.

OBJECTIVES: Return visits to the emergency department (ED) and subsequent readmissions are common for patients who are unable to fill their prescriptions. We sought to determine if dispensing medications to patients in an ED was a cost-effective way to decrease return ED visits and hospital admissions for skin and soft tissue infections (SSTIs). METHODS: A retrospective review of ED visits for SSTIs, during the 24 weeks before and after the implementation of a medication dispensing program, was conducted. Charts were analyzed for both ED return visits and hospital admissions within 7 days and 30 days of the initial ED visit. Return visits were further reviewed to determine if the clinical conditions on subsequent visits were related to the initial ED presentation. A cost analysis comparing the cost of treatment to cost savings for return visits was also performed. RESULTS: Before the implementation of the medication dispensing program, the return rate in 7 days for the same condition was 9.1% and the rate of admission was 2.8%. The return rate for the same condition in 8-30 days was 2.1% and the rate of admission was 1.0%. After the implementation of the medication dispensing program, the return rate for the same condition in 7 days was 8.0%, and the admission rate was 1.7%. The return rate for the same condition in 8-30 days was 0.8%, and the admission rate was 0%. The total cost of dispensed medications was $4050, while total cost savings were estimated to be $95,477. CONCLUSION: A medication dispensing program in the ED led to a reduction in return visits and admissions for SSTIs at both 7 days and 30 days. For a cost of only $4050, an estimated total of $95,477 was saved. A medication dispensing program is a cost-effective way to reduce return visits to the ED and subsequent admissions for certain conditions.

Critical Appraisal of Anesthesiology Educational Research for 2020.

Background: This study reviews and appraises the articles published about anesthesiology education in 2020. The objective is to highlight high-quality evidence while showcasing articles with innovative ideas and high relevance to the practices of the anesthesiology education community. Methods: Three Ovid MEDLINE databases, Embase.com, ERIC, PsycINFO, and PubMed were searched, followed by a manual review of articles published in the highest impact factor journals in both the fields of anesthesiology and medical education. Abstracts were double screened, and quantitative articles were subsequently scored by 3 randomly assigned raters. Qualitative studies were scored by 2 raters. Two different rubrics were used for scoring quantitative and qualitative studies. In addition, reviewers rated each article on its overall quality to create an additional list of top articles based solely on the opinion of the reviewers. Results: A total of 2,491 citations were identified through the search criteria and the manual review. Of those, 61 articles met the inclusion criteria (57 quantitative and 4 qualitative). The top 12 quantitative papers and the top qualitative papers with the highest scores are reported and summarized. Conclusions: We found that teaching clinical procedures continues to be a topic of interest, with more studies of improved rigor identified. New trends in wellness studies and increasing attention to distance learning and technology-assisted instructional methods were additional topics covered over the year.

Critical Appraisal of Anesthesiology Educational Research for 2019.

Background: This study reviews and appraises the articles published about anesthesiology education in 2019. Through this critical appraisal, those interested in anesthesiology education are able to quickly review literature published during this year and explore innovative ways to improve education for all those involved in the practice of anesthesiology. Methods: Three Ovid MEDLINE databases, Embase.com, ERIC, and PsycINFO were searched followed by a manual review of articles published in the highest impact factor journals in both the fields of anesthesiology and medical education. Abstracts were double-screened and quantitative articles were subsequently scored by 3 randomly assigned raters. Qualitative studies were scored by 2 raters. Two different rubrics were used for scoring quantitative and qualitative studies; both allowed for scores ranging from 1 to 25. In addition, reviewers rated each article on its overall quality to create an additional list of top articles based solely on the opinion of the reviewers. Results: A total of 2374 unique citations were identified through the search criteria and the manual review. Of those, 70 articles met the inclusion criteria (62 quantitative and 8 qualitative). The top 12 quantitative papers and the top 2 qualitative papers with the highest scores were reported and summarized.Conclusions: This critical appraisal continues to be a useful tool for those working in anesthesiology education by highlighting the best research articles published over the year. Highlighting trends in medical education research in anesthesiology can help those in the field to think critically about the direction of this type of research.

Critical Appraisal of Anesthesiology Educational Research for 2018.

BACKGROUND: Through a critical appraisal of the education research in anesthesiology, this article enables those interested in the field to read the high-quality articles for the past year and possibly implement these evidence-based interventions and concepts into practice. This study reviews and appraises all medical education studies published in 2018 in anesthesiology and summarizes the highest-rated articles evaluated. METHODS: Three Ovid MEDLINE databases, Embase.com, ERIC, PsycINFO, and PubMed were searched followed by a manual review of articles published in the highest impact factor journals in both the fields of anesthesiology and medical education. Abstracts were double-screened and quantitative articles subsequently scored by 3 randomly assigned raters. Qualitative studies were scored by 2 raters. Two different rubrics were used for scoring quantitative and qualitative studies, both allowed for scores ranging from 1 to 25. RESULTS: A total of 888 unique citations were identified through the search criteria. Of those, 39 articles met the inclusion criteria (36 quantitative and 3 qualitative). The top 11 quantitative papers and the top qualitative paper with the highest scores were reported and summarized. CONCLUSIONS: As the second article to critically review the literature available for education in anesthesiology, we are able to add to this annual series to help further disseminate the articles of the highest quality in anesthesiology education. Because this is only the second year, we can only report on initial suggestions of trends that we hope will help guide future research.

Critical Appraisal of Anesthesiology Educational Research for 2017.

Background Critical appraisals provide a method for establishing the status of an area of study or evaluating the effectiveness of literature within it. The purpose of this study was to review and appraise studies published in 2017 on medical education in anesthesiology and to provide summaries of the highest-quality medical education research articles in the field. Methods Three Ovid MEDLINE databases, Embase.com, Education Resources Information Center (ERIC), and PsycINFO, were searched followed by a manual review of articles published in the highest impact factor journals in both the fields of anesthesiology and medical education. Abstracts were double-screened and quantitative articles subsequently scored by three randomly assigned raters. Qualitative studies were scored by two raters. Two different rubrics were used for scoring quantitative and qualitative studies, both allowed for scores ranging from 1-25. Results A total of 864 unique citations were identified through the search criteria. Of those, 62 articles met the inclusion criteria, with 59 quantitative and three qualitative. The top 10 papers with the highest scores were reported and summarized. Discussion As the first article to critically review the literature available for education in anesthesiology, we hope that this study will serve as the first manuscript in an annual series that will help individuals involved in anesthesiology education gain an understanding of the highest-quality research in the field. Once this process is repeated, trends can be tracked and serve as a resource to educators and researchers in anesthesiology for years to come.

An Analysis of the Top-cited Articles in Anesthesiology Education Literature.

BACKGROUND: In the same way that impact factor is calculated for journals, the number of citations an article receives can indicate its influence or value to a particular field. This study was designed to identify the most frequently cited articles in anesthesiology education to yield insight into which articles have been most useful for researchers in ongoing research and publication. METHODS: The Web of Science database was searched to capture the top-cited articles in anesthesiology education both in anesthesiology and nonanesthesiology journals. Results were sorted by the most frequently cited. The top 40 cited articles were identified. Articles were included if they (1) related to anesthesiology or included anesthesiologists as subjects and (2) were related to the education of current or future anesthesiologists. The full text was analyzed, and themes were identified. RESULTS: There was a total of 2923 citations of articles in anesthesiology journals and 924 citations of articles in nonanesthesiology journals. Thirty-two of 40 articles (80%) were research studies. Twenty-four of 40 (60%) were about teaching methods. Twenty-five of 40 (63%) focused on simulation, and 31 of 40 (78%) had residents as the subjects. Twenty-eight of 40 (70%) articles were about either case management (15) or learning procedures (13). CONCLUSIONS: This study identifies the most widely cited articles in anesthesiology education. Common themes included procedural learning, interventional research study designs, simulation, and studies involving residents as subjects. This article may be a resource to anesthesiology education researchers to identify what articles are widely cited by other researchers.