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Ethical and Legal Issues

Effects of a Dedicated Regional Psychiatric Emergency Service on Boarding of Psychiatric Patients in Area Emergency Departments

Volume XV, Issue 1, February 2014
Scott Zeller, MD et al.

This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the “Alameda Model” on boarding times and hospitalization rates for psychiatric patients in area EDs.

This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the “Alameda Model” on boarding times and hospitalization rates for psychiatric patients in area EDs.

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Ethical and Legal Issues

The Alameda Model: An Effort Worth Emulating

Volume XV, Issue 1, February 2014
Aimee Moulin, MD, et al.

In 2009 Alameda placed 11.0 involuntary holds per 1,000 population, while the next highest county in California only placed 6.4 per 1,000 population.5 This may suggest instead that some of Alameda’s mental health patients would not have been placed on an involuntary hold in other California counties in the first place, increasing the proportion of lower acuity psychiatric emergencies and thus accounting for the high discharge rate.

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Practice Variability

Variation in Specialists’ Reported Hospitalization Practices of Children Sustaining Blunt Abdominal Trauma

Introduction: Children with blunt abdominal trauma (BAT) are often hospitalized despite no intervention. We identified factors associated with emergency department (ED) disposition of children with BAT and differing computed tomography (CT) findings.

Conclusion: Substantial variation exists between specialties in reported hospitalization practices of asymptomatic children after abdominal trauma with minor CT findings. Better evidence is needed to guide disposition decisions.

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Practice Variability

Variation in Specialists’ Reported Hospitalization Practices of Children Sustaining Blunt Head Trauma

Introduction: Questions surround the appropriate emergency department (ED) disposition of children who have sustained blunt head trauma (BHT). Our objective was to identify physician disposition preferences of children with blunt head trauma (BHT) and varying computed tomography (CT) findings.

Conclusion: Substantial variation exists between specialties in reported hospitalization practices of neurologically-normal children with BHT and traumatic CT findings.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

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Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org

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WestJEM
ISSN: 1936-900X
e-ISSN: 1936-9018

CPC-EM
ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.