Elizabeth A Linton1, Dania A Goodin2, Jane S Hankins3, Julie Kanter4, Liliana Preiss5, Jena Simon6, Kimberly Souffront7, Paula Tanabe8, Robert Gibson9, Lewis L Hsu10, Allison King11, Lynne D Richardsona12, Jeffrey A Glassberg1. 1. Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. 2. Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: Dania.Goodin@mountsinai.org. 3. Department of Hematology, St Jude Children's Research Hospital, Memphis, TN. 4. Division of Hematology and Oncology, University of Alabama at Birmingham School of Medicine, Birmingham, AL. 5. RTI International, Research Triangle Park, NC. 6. Department of Nursing, Icahn School of Medicine at Mount Sinai, New York, NY. 7. Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Center for Nursing Research and Innovation, Icahn School of Medicine at Mount Sinai, New York, NY. 8. School of Nursing, Duke University, Durham, NC. 9. Department of Emergency Medicine, Medical College of Georgia, Augusta, GA. 10. Division of Pediatric Hematology-Oncology, University of Illinois, Chicago, IL. 11. Department of Pediatric Hematology and Oncology, Washington University in St. Louis, St. Louis, MO. 12. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Abstract
STUDY OBJECTIVE: Guided by an implementation science framework, this needs assessment identifies institutional-, provider-, and patient-level barriers to care of sickle cell disease (SCD) in the emergency department (ED) to inform future interventions conducted by the multicenter Sickle Cell Disease Implementation Consortium. METHODS: The consortium developed and implemented a validated needs assessment survey administered to a cross-sectional convenience sample of patients with SCD and ED providers caring for them. In total, 516 adolescents and adults with SCD and 243 ED providers from 7 and 5 regions of the United States, respectively, responded to the ED care delivery for SCD survey. RESULTS: Survey results demonstrated that 84.5% of respondents with SCD have an outpatient provider who treats many patients with SCD. In the ED, 54.3% reported not receiving care fast enough and 46.0% believed physicians did not care about them and believed similarly of nurses (34.9%). Consequently, 48.6% of respondents were "never" or "sometimes" satisfied with their ED care. Of surveyed ED providers, 75.1% were unaware of the National Heart, Lung, and Blood Institute recommendations for vaso-occlusive crises, yet 98.1% were confident in their knowledge about caring for patients with SCD. ED providers identified the following factors as barriers to care administration: opioid epidemic (62.1%), patient behavior (60.9%), crowding (58.0%), concern about addiction (47.3%), and implicit bias (37.0%). CONCLUSION: The results underscore that many patients with SCD are dissatisfied with their ED care and highlight challenges to optimal care on the practice, provider, and patient levels. Exploring these differences may facilitate improvements in ED care.
STUDY OBJECTIVE: Guided by an implementation science framework, this needs assessment identifies institutional-, provider-, and patient-level barriers to care of sickle cell disease (SCD) in the emergency department (ED) to inform future interventions conducted by the multicenter Sickle Cell Disease Implementation Consortium. METHODS: The consortium developed and implemented a validated needs assessment survey administered to a cross-sectional convenience sample of patients with SCD and ED providers caring for them. In total, 516 adolescents and adults with SCD and 243 ED providers from 7 and 5 regions of the United States, respectively, responded to the ED care delivery for SCD survey. RESULTS: Survey results demonstrated that 84.5% of respondents with SCD have an outpatient provider who treats many patients with SCD. In the ED, 54.3% reported not receiving care fast enough and 46.0% believed physicians did not care about them and believed similarly of nurses (34.9%). Consequently, 48.6% of respondents were "never" or "sometimes" satisfied with their ED care. Of surveyed ED providers, 75.1% were unaware of the National Heart, Lung, and Blood Institute recommendations for vaso-occlusive crises, yet 98.1% were confident in their knowledge about caring for patients with SCD. ED providers identified the following factors as barriers to care administration: opioid epidemic (62.1%), patient behavior (60.9%), crowding (58.0%), concern about addiction (47.3%), and implicit bias (37.0%). CONCLUSION: The results underscore that many patients with SCD are dissatisfied with their ED care and highlight challenges to optimal care on the practice, provider, and patient levels. Exploring these differences may facilitate improvements in ED care.
Authors: Hussain R Yusuf; Hani K Atrash; Scott D Grosse; Christopher S Parker; Althea M Grant Journal: Am J Prev Med Date: 2010-04 Impact factor: 5.043
Authors: Lisa D DiMartino; Ana A Baumann; Lewis L Hsu; Julie Kanter; Victor R Gordeuk; Jeffrey Glassberg; Marsha J Treadwell; Cathy L Melvin; Joseph Telfair; Lisa M Klesges; Allison King; Ted Wun; Nirmish Shah; Robert W Gibson; Jane S Hankins Journal: Am J Hematol Date: 2018-10-17 Impact factor: 13.265
Authors: Matthew P Smeltzer; Kristen E Howell; Marsha Treadwell; Liliana Preiss; Allison A King; Jeffrey A Glassberg; Paula Tanabe; Sherif M Badawy; Lisa DiMartino; Robert Gibson; Julie Kanter; Lisa M Klesges; Jane S Hankins Journal: BMJ Open Date: 2021-11-17 Impact factor: 2.692