Other Components & Core Competencies Flashcards
What represents the largest percentage of medical errors in ED setting?
Medication errors
Classes of recommendation
Class I - Benefit»_space;> Risk; procedure/tx SHOULD be performed/administered
Class IIa - Benefit»_space; Risk; It is REASONABLE to perform procedure/administer tx
Class IIb - Benefit >/= Risk; Procedure/Tx MAY BE CONSIDERED
Class III - Risk >/= Benefit; Procedure/Tx should NOT be performed
Level A vs. Level B vs. Level C recommendations
Level A: multiple populations evaluated and data derived from multiple RCTs or meta-analyses
Level B: limited populations evaluated and data derived from a single RCT or non-randomized studies
Level C: very limited populations evaluated and only consensus opinion of experts, case studies, or standard of care
Which clinical decision rule commonly used in emergency medicine practice meets Level 1 criteria for ease of use, rate of use, and effect on patient satisfaction?
Ottawa Ankle rules
Level I Trauma Center Categorization
- Highest level of surgical care to trauma patients
- Regional referral center
- Required to have full range of specialists available 24 hours a day
- Capacity to provide advanced, tertiary care
- Research program
- Provides public education
Level II Trauma Center Categorization
- Works in collaboration with a Level I center
- Capable of providing definitive care similar to Level I but unable to provide as intricate treatment
- Required to have some specialty and surgical specialists available 24 hours a day
- Not required to have an ongoing research or a surgical residency program
Level III Trauma Center Categorization
- Does not have the full availability of specialists but does have resources for emergency resuscitation, surgery, and intensive care of most trauma patients
- Has transfer agreements with Level I or Level II trauma centers that provide back-up resources for the care of exceptionally severe injuries
Level IV Trauma Center Categorization
- Provides initial evaluation, stabilization, diagnostic capabilities, and transfer to a higher level of care
- A trauma-trained nurse is immediately available, and physicians are available upon the patient’s arrival to the ED
- Transfer agreements exist with other trauma centers of higher levels
What entity is responsible for designating trauma centers and regionalization of trauma care?
Individual states
What is the definition of cost-effectiveness analysis?
Cost and benefits are measured independently and the relative value of an intervention measured as the additional cost to achieve an incremental health benefit is determined
What is cost-utility analysis?
A type of cost-effectiveness analysis where life expectancy, adjusted for the benefits and/or harms associated with the specific strategy, is the metric whereby effectiveness is measured
What is cost-benefit analysis?
Assigns a monetary value to health outcomes - not generally done in healthcare
What is cost-identification analysis?
Examining costs of care with the assumption that there are equal health benefits for each potential option
What is the incremental cost-effectiveness ratio?
The ratio between the difference in costs and the difference in benefits of two interventions
What are four different types of costs?
Direct medical costs
Direct nonmedical costs (e.g. transportation to hospital)
Time or indirect morbidity and mortality (e.g. lost wages from missed work)
Intangible (e.g. pain and suffering)
