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- W2167718271 abstract "Even before the ED sorting process was revolutionized and expanded from 3 to 5 acuity levels, social, economic, and market forces were converging to cause growing patient volumes and ED crowding. Driving forces then and now include serial recessions, cuts in health care funding by states and localities, the closing of one third of the country’s emergency departments during the 20 years preceding 2009, an aging population, inpatient bed capping with resultant ED boarding of admitted patients, hospital staffing cuts, increasing visits for nonurgent services by persons without access to care elsewhere, and competition for lower acuity paying patients served alongside the growing numbers of uninsured patients. 1 Bernstein J Changes in Health Care Financing and Organization Issue Brief: Impact of the Economy on Health Care. Robert Wood Johnson Foundation, Princeton, NJ2009 Google Scholar , 2 Conklin TP Health care in the United States: an evolving system. Mich Fam Rev. Fall 2002; (Accessed September 26, 2013)http://quod.lib.umich.edu/m/mfr/4919087.0007.102?rgn=main;view=fulltext Google Scholar , 3 Trzeciak S Rivers EP Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. J Emerg Med. 2003; 20: 402-405 Crossref Scopus (573) Google Scholar The Emergency Severity Index (ESI) now provides a more refined system for determining acuity simply because of its more thinly sliced acuity levels. It also has an expectation of faster front-door acuity decisions, but when applied as an isolated acuity labeling system without being “married” to expedited flow strategies, ESI cannot provide what is needed to drive uninterrupted patient flow. Sally B. Sulfaro, Member, Little Traverse Bay Chapter 345, is Emergency Department Operational Performance Consultant and Principal, EpisodiCare Consulting, PLLC, Fairview, MI." @default.
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- W2167718271 date "2013-11-01" @default.
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- W2167718271 title "Triage Evolution: From Labeling to Streaming" @default.
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- W2167718271 doi "https://doi.org/10.1016/j.jen.2013.09.010" @default.
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