Evidence map›Paper›PMID 25936477›Full record

ArticleThe American journal of emergency medicine2015

Emergency medicine in the Veterans Health Administration-results from a nationwide survey.

Michael J Ward, Sean P Collins, Jesse M Pines, Curt Dill, Gary Tyndall, Chad S Kessler

Abstract read
In one paragraph

Article in The American journal of emergency medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michael J WardDepartment of Emergency Medicine, Vanderbilt University School of Medicine, Health Services Research, VA Tennessee Valley Healthcare System, 1313 21st Ave, Nashville, TN 37232. Electronic address: michael.j.ward@vanderbilt.edu.
Sean P CollinsDepartment of Emergency Medicine, Vanderbilt University School of Medicine, Health Services Research, VA Tennessee Valley Healthcare System, 1313 21st Ave, Nashville, TN 37232.
Jesse M PinesDepartment of Emergency Medicine, George Washington University, Washington, DC.
Curt DillDepartment of Emergency Services, NYU School of Medicine, VA New York Harbor Healthcare Center New York, NY.
Gary TyndallEmergency Services, Syracuse VAMC, National Director for VA Emergency Medicine, Syracuse, NY.
Chad S KesslerDurham VA Medical Center, Duke University School of Medicine, Durham, NC.

Funding

The Vanderbilt Emergency Medicine Research Training Program (VEMRT)K12HL109019 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI COLLINS, SEAN PATRICK, STORROW, ALAN B · 2011 to 2015
$3.7M
NHLBI NIH HHS K12 HL109019NHLBI NIH HHS K12HL109019
6 · The paper itself

Abstract

STUDY

objectiveWe describe emergency physician staffing, capabilities, and academic practices in US Veterans Health Administration (VHA) emergency departments (EDs).

methodsAs part of an ongoing process improvement effort for the VHA emergency care system, VHA-wide surveys are conducted among ED medical directors every 3 years. Web-based surveys of VHA ED directors were conducted in 2013 on clinical operations and academic program development. We describe the results from the 2013 survey. When available, we compare responses with the previously administered survey from 2010.

resultsA total of 118 of 118 ED directors filled out the survey in 2013 (100% response rate). Respondents reported that 45.5% of VHA emergency physicians are board certified in emergency medicine, and 95% spend most their time in direct patient care. Clinical care is also provided by part-time (<0.5 full-time employee equivalent) emergency physicians in 59.3% of EDs. More than half of EDs (57%) provide on-site tissue plasminogen activator for acute ischemic stroke patients, and only 39% can administer tissue plasminogen activator 24 hours per day, 7 days per week. Less than half (48.3%) of EDs have emergency Obstetrics and Gynecology consultation availability. Most VHA EDs (78.8%) have a university affiliation, but only 21.5% participated in the respective academic emergency medicine program.

conclusionsVeterans Health Administration emergency physicians have primarily clinical responsibilities, and less than half have formal emergency medicine board certification. Despite most VHA EDs having university affiliations, traditional academic activities (eg, teaching and research) are performed in only 1 in 3 VHA EDs. Less than half of VHA EDs have availability of consulting services, including advanced stroke care and women's health.

Indexed as

Cross-Sectional StudiesData CollectionEmergency MedicineEmergency Service, HospitalFaculty, MedicalFibrinolytic AgentsGynecologyHospitals, UniversityHospitals, VeteransHumansObstetricsPersonnel Staffing and SchedulingPractice Patterns, Physicians'StrokeTissue Plasminogen ActivatorUnited StatesFibrinolytic AgentsTissue Plasminogen Activator

Identifiers

PMID25936477
PMCPMC4476937

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.