Ashley Blachford, Author at Journal of Urgent Care Medicine

Antibiotic Stewardship and Sinusitis: A Quality Improvement Project

Urgent message: Acute sinusitis poses frequent challenges in urgent care where patient volumes are high and patient satisfaction is valued. An educational session and an algorithmic clinical decision-support tool were implemented in a multisite urgent care quality improvement project which resulted in a statistically significant reduction in antibiotic prescribing for acute sinusitis. ABSTRACT Background Sinusitis is a common upper respiratory condition seen in urgent care centers, as it is in primary care practices and, increasingly …

Finding Urgent Care (and the Value of Recognizing a Specialty)

I arrived in New Zealand 11 years ago, a doctor without direction and certainly with no inkling of urgent care. I was one of those doctors who had always hoped to find their ultimate career path whilst at university. Alas, whilst I was able to remove some options (here’s looking at you Ob/Gyn) no single specialty sufficiently inspired me to follow that rabbit hole through to its conclusion. So, my medical career began with an …

Can Employers Mandate the COVID-19 Vaccine?

Urgent message: Based on precedent, urgent care operators and other employers can mandate the COVID-19 vaccine when available, subject to reasonable accommodation for exemptions, which are limited when an employee’s role is public- or patient-facing. As we strain our eyes to see the light at the end of the tunnel in this pandemic, many urgent care centers will continue to have front office staff, medical assistants, and providers interacting with the public. In fact, research …

Turning Back the Tide of Antibiotic Resistance, One (Unfilled) Prescription at a Time

According to JUCM’s own chart research, antibiotics are the most-prescribed class of medications in urgent care. This is not surprising, given that six of the top 10 presenting complaints in urgent care encompass possible diagnoses for which an antibiotic could be an appropriate choice.1 Still, there’s no denying that antibiotics have been overprescribed across the board—in retail clinics, emergency room, traditional primary care offices, and urgent care. This was clearly validated in a research …

Streptococcal Pharyngitis and Its Sidekicks: Common and Uncommon Etiologies

Urgent message: Pharyngitis is a common chief complaint in urgent care, but not all sore throats are streptococcal (strep) pharyngitis. Delayed diagnosis and treatment of some causes of sore throat can lead to catastrophic outcomes. Epidemiology Acute pharyngitis accounts for 1%-2% of all visits in the ambulatory setting.1 Most pharyngitis seen in urgent care is viral in etiology. The most common bacterial cause of pharyngitis is group A beta hemolytic Streptococcus (GABHS), which is responsible …

Antibiotic Stewardship in Pediatric Acute Otitis Media—Pearls and Pitfalls

Urgent message: Acute otitis media (AOM) is the leading diagnosis for antibiotic prescribing in pediatric patients. As antibiotic stewardship becomes more essential in preventing antibiotic resistance, safe and effective management of AOM becomes all the more important in urgent care. The treatment path should reflect nuances in management to inform decisions regarding the necessity of antibiotics—and if they are deemed necessary, targeting the type, delivery vehicle, and duration to keep a narrow treatment effect. When …

A 69-Year-Old Female with Hypertension, Dyslipidemia, and a Constellation of Otolaryngologic Symptoms

Urgent message: Epiglottitis is classically viewed as a pediatric disease, but has become increasingly common in the adult population. While symptoms may present as an isolated sore throat, they can quickly progress to complete airway compromise with need for emergency cricothyroidotomy. Due to the high risk for morbidity and mortality, urgent care providers must maintain a high index of suspicion to avoid misdiagnosing a potentially catastrophic disease. Zachary DePriest, MS, PA-C INTRODUCTION Adult epiglottitis (AE) …

Abstracts in Urgent Care November 2020

Antibiotics (or Not?) for Dog Bites Scaring the Quest for Antibiotics Out of Patients Post-Op Antibiotics in Complex Appendicitis How Long Should Sepsis Patients Receive Antibiotics? Times Are Changing for Patients with Allergic Rhinitis Avijit Barai MBBS, MRCS, MSc (Critical Care), PgCertCPU, FRNZCUC Prophylactic Antibiotics for Dog Bites Key point: The majority of the patients presenting to emergency room with dog bites receive prophylactic antibiotics either in the hospital or on discharge. About one quarter …

Looking Forward to 2021

2020 has been a rough year for all of us, and everybody is eagerly awaiting 2021. One thing for urgent care providers to look forward to is simplified documentation standards for evaluation and management guidelines. Current documentation guidelines are over 20 years old. A lot has changed in that time, most importantly the adoption of electronic medical records (EMR). Thus, outdated expectations have created “note bloat,” unnecessary work, and contributed to provider burn out. The …

The COVID-19 Pandemic Is Making Burnout Worse for Physicians Already in Crisis

Urgent message: For several years, JUCM has reported on the national crisis of “provider burnout.” New data related to the COVID-19 pandemic indicate a need to revisit the topic. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. No part of the world has been left untouched by the COVID-19 pandemic. Currently, many urgent care centers are in crisis …