Emergency department visits among First Nations female adults in Alberta: a population-based study.

Objective: Emergency departments (EDs) serve as a critical first access point for receiving healthcare for many First Nations members. However, ED experiences differ between First Nations and non-First Nations patients. Our objective is to quantify differences in ED visit characteristics for First Nations female and non-First Nations female adult patients in Alberta.

The relationship between prolonged emergency department (ED) wait times and short-term all-cause mortality: an analysis of multi-institutional administrative data in Alberta.

Objective: ED wait times have been linked to adverse patient outcomes, including increased mortality. We sought to assess the consequences of ED wait times on patient outcomes.

Methods: We conducted a cohort study using administrative data from the 14 Alberta highest-volume adult EDs (2017-2022).

A Better Way to Care for Long-Term Care Residents in Times of Medical Urgency: An Implementation Intervention Using a Stepped-Wedge Design to Reduce Unnecessary Acute Care Transfers.

Objective: Approximately 25% of long-term care (LTC) residents are transferred to an emergency department (ED) when experiencing an acute change in health status. This can place strain on health care resources and negatively impact residents. Many residents' conditions could be managed within LTC if appropriate supports were provided.

Potentially Avoidable Emergency Department Utilization by Persons With Psoriatic Arthritis and Radiographic Axial Spondyloarthritis: A Population-Based Cohort Study.

Objective: Greater accessibility to ambulatory services may mitigate emergency department (ED) presentations for lower acuity issues. This study examined ED utilization patterns for individuals with psoriatic arthritis (PsA) and radiographic axial spondyloarthritis (r-axSpA) in a universal access healthcare setting.

Methods: Linked population-based administrative datasets in Alberta, Canada (fiscal years 2007/2008-2017/2018) were assessed for yearly ED visit frequency, timing, triage acuity, most responsible diagnoses, and disposition for persons with PsA and r-axSpA.

Interventions to improve equity in emergency departments for Indigenous people: A scoping review.

Background: Disparities in health outcomes, including increased chronic disease prevalence and decreased life expectancy for Indigenous people, have been shown across settings affected by white settler colonialism including Canada, the United States, Australia, and New Zealand. Emergency departments (EDs) represent a unique setting in which urgent patient need and provider strain interact to amplify inequities within society. The aim of this scoping review was to map the ED-based interventions aimed at improving equity in care for Indigenous patients in EDs.

The development and validation of a conceptual definition of avoidable transitions from long-term care to the emergency department: A mixed methods study.

Background/objectives: Transitions to and from Emergency Departments (EDs) can be detrimental to long-term care (LTC) residents and burden the healthcare system. While reducing avoidable transfers is imperative, various terms are used interchangeably including inappropriate, preventable, or unnecessary transitions. Our study objectives were to develop a conceptual definition of avoidable LTC-ED transitions and to verify the level of stakeholder agreement with this definition.

Emergency department utilization by persons with rheumatoid arthritis: a population-based cohort study.

Some emergency department (ED) visits by persons with rheumatoid arthritis (RA) may be avoidable. This study aims to describe ED use by persons with RA in Alberta, Canada over a 10-year period. Using linked population-based administrative datasets, the annual frequency of ED visits, timing of visits, acuity at presentation assessed (Canadian Triage Acuity Scale (CTAS)), return visits within 72 h, and final disposition were assessed.

Deciding to Attend the Emergency Department: Experiences of Patients With Inflammatory Arthritis.

Objective: Patients may use emergency departments (EDs) to meet their health needs when ambulatory care systems are not sufficient. We aim to describe contributing factors to the decision made by persons with inflammatory arthritis (IA) to present to the ED, as well as their experiences of ED care and postdischarge follow-up.

Methods: An embedded mixed-methods approach was taken to contextualize quantitative data with associated free-text responses from an online survey distributed to residents of Alberta with a known IA condition and an ED visit.

Leaving emergency departments without completing treatment among First Nations and non-First Nations patients in Alberta: a mixed-methods study.

Background: Our previous research showed that, in Alberta, Canada, a higher proportion of visits to emergency departments and urgent care centres by First Nations patients ended in the patient leaving without being seen or against medical advice, compared with visits by non-First Nations patients. We sought to analyze whether these differences persisted after controlling for patient demographic and visit characteristics, and to explore reasons for leaving care.

Methods: We conducted a mixed-methods study, including a population-based retrospective cohort study for the period of April 2012 to March 2017 using provincial administrative data.

Exploring paramedic care for First Nations in Alberta: a qualitative study.

Background: Prior work has shown that a greater proportion of First Nations patients than non-First Nations patients arrive by ambulance to emergency departments in Alberta. The objective of this study was to understand First Nations perspectives on transitions in care involving paramedics, and paramedic perspectives on serving First Nations communities.

Methods: Participants for this participatory qualitative study were selected by means of purposive sampling through author networks, established relationships and knowledge of the Alberta paramedicine system.

Incidence of Pressure Injury Among Older Adults Transitioning from Long-term Care to the ED.

Objective: To identify sociodemographic, health condition, and organizational/process factors associated with pressure injury (PI) incidence during older adults' emergency transitions from long-term care (LTC) to the ED.

Methods: Emergency transitions were tracked for older adults within included LTC facilities to participating EDs in two urban centers located in provinces in Canada. Binary logistic regression was used to examine the influence of sociodemographic, service use, and client health and function factors on the incidence of PIs during transitions from LTC facilities to EDs.

Transitions in health care settings for frequent and infrequent users of emergency departments: a population-based retrospective cohort study.

Background: Efforts to reduce emergency department (ED) volumes often target frequent users. We examined transitions in care across ED, hospital, and community settings, and in-hospital death, for high system users (HSUs) compared to controls.

Methods: Population-based databases provided ED visits and hospitalizations in Alberta and Ontario, Canada.

Action, Accountability and Transparency for Indigenous Health Systems Safety.

Anti-Indigenous racism is prevalent in Canada, especially within healthcare systems. Consequences are catastrophic, including deaths of Indigenous patients. Systems change and critical education guided by the Indigenous Peoples and research into how racism operates within healthcare settings are needed.

Buprenorphine/naloxone initiation and referral as a quality improvement intervention for patients who live with opioid use disorder: quantitative evaluation of provincial spread to 107 rural and urban Alberta emergency departments.

Objectives: Opioid use disorder is a major public health concern that accounts for a high number of potential years of life lost. Buprenorphine/naloxone is a recommended treatment for opioid use disorder that can be started in the emergency department (ED). We developed an ED-based program to initiate buprenorphine/naloxone for eligible patients who live with opioid use disorder, and to provide unscheduled, next-day follow-up referrals to an opioid use disorder treatment clinic (in person or virtual) for continuing patient care throughout Alberta.

A first look at consistency of documentation across care settings during emergency transitions of long-term care residents.

Background: Documentation during resident transitions from long-term care (LTC) to the emergency department (ED) can be inconsistent, leading to inappropriate care. Inconsistent documentation can lead to undertreatment, inefficiencies and adverse patient outcomes. Many individuals residing in LTC have some form of cognitive impairment and may not be able to advocate for themselves, making accurate and consistent documentation vital to ensuring they receive safe care.

Impacts of racism on First Nations patients' emergency care: results of a thematic analysis of healthcare provider interviews in Alberta, Canada.

Background: First Nations people experience racism in society and in the healthcare system. This study aimed to document emergency care providers' perspectives on care of First Nations patients. First Nations research partner organizations co-led all aspects of the research.

Age-varying effects of repeated emergency department presentations for children in Canada.

Objectives: Repeated presentations to emergency departments (EDs) may indicate a lack of access to other health care resources. Age is an important predictor of frequent ED use; however, age-varying effects are not generally investigated. This study examines the age-specific effects of predictors on ED presentation frequency for children in Alberta and Ontario, Canada.

Assessing quality of older persons' emergency transitions between long-term and acute care settings: a proof-of-concept study.

Background: Long-term care (LTC) residents frequently experience transitions in the location of more advanced care delivery, including receiving emergency department (ED) care. In this proof-of-concept study, we aimed to determine if we could identify measures in quality of care across transitions from LTC to the ED, via emergency medical services and back, by applying Institute of Medicine (IOM) Quality of Care Domains to an existing dataset.

Methods: In the Older Persons' Transitions in Care (OPTIC) study, we collected information on residents' transitions in two Western Canadian cities.

Being a member of a novel transitional case management team for patients with unstable housing: an ethnographic study.

Background: Homeless and unstably housed individuals face barriers in accessing healthcare despite experiencing greater health needs than the general population. Case management programs are effectively used to provide care for this population. However, little is known about the experiences of providers, their needs, and the ways they can be supported in their roles.

Characteristics of Pediatric Frequent Users of Emergency Departments in Alberta and Ontario.

Objectives: Emergency department (ED) volumes have drawn attention to frequent users but less attention has been paid to children. This study examined sociodemographic and ED presentation characteristics of pediatric high-system ED users (HSUs) in 2 provinces in Canada.

Methods: Cohorts of HSUs were created from the National Ambulatory Care Reporting System in 2015/2016 for children with the top 10% of ED presentations.

Connect 2 Care, a Novel Community Outreach Program for Vulnerably Housed Patients With High Acute Care Use: A Mixed-Methods Study Protocol.

Vulnerably housed individuals, especially those experiencing homelessness, have higher acute care use compared with the general population. Despite available primary care and social services, many face significant challenges accessing needed services. Connect 2 Care (C2C) is a novel transitional case management program that includes registered nurses and health navigators with complementary expertise in chronic disease management, mental health and addictions, social programs, community health, and housing, financial, transportation and legal resources.

Opioid use disorder treatment disruptions during the early COVID-19 pandemic and other emergent disasters: a scoping review addressing dual public health emergencies.

Background: During public health emergencies, people with opioid use disorder (PWOUD) may be particularly impacted. Emergent disasters such as the COVID-19 pandemic disrupt already-strained harm reduction efforts and treatment availability. This study aims to answer three research questions.