Journal of Urgent Care Medicine

Antibiotic Duration for Skin and Soft Tissue Infections in Pediatric Urgent Care

Urgent message: Approximately one quarter of pediatric ambulatory visits result in antibiotic prescriptions, with over one third of those exceeding guideline-recommended durations. Factors that influence urgent care providers toward longer durations have not been studied previously. Megan Hamner, MD; Amanda Nedved, MD; Holly Austin, MD; Donna Wyly, RN, MSN, CPNP-AC, PPCNP-BC; Alaina Burns, PharmD, BCPPS; Brian Lee, PhD, MPH; and Rana E. El Feghaly MD, MSCI Citation: Hamner M, Nedved A, Austin H, Wyly D, …

Antibiotic Prescribing Patterns for Sinusitis in an Urgent Care and Convenience Care Setting: A Quality Improvement Project

Urgent Message: Inappropriate antibiotic prescribing in the outpatient setting has been a longstanding public health challenge. An educational session implemented in a large Midwestern healthcare system group of urgent care and convenience care clinics resulted in a statistically significant reduction in antibiotic prescribing for acute sinusitis and a statistically significant increase in antibiotic guideline adherence. Dr. Amy K. Rasmussen, DNP, FNP-C ABSTRACT Background: Inappropriate antibiotic prescribing in the outpatient setting is a longstanding problem and …

SARS-CoV-2 and Influenza Type A/B Infection Rates: A Report of a Federal Qualified Health Care Center-Urgent Care Department During Omicron Wave In Rhode Island

Urgent message: Influenza types A and B have demonstrated a pattern that increases patient volumes in urgent care centers during “flu season.” But the COVID-19 virus, including its different variants, continues to have different patterns throughout multiple waves and has shown to overcome/oppress other predictable viruses. Cesar Mora Jaramillo, MD, FAAFP, FCUCM Citation: Jaramillo CM. SARS-CoV-2 and influenza type A/B Infection rates: a report of a federal qualified health care center-urgent care department during Omicron …

Cost-Effective Ambulatory Care for Emergency Department Avoidance

Urgent message: Industry perception is that urgent care offers the opportunity for potentially substantial cost savings while also providing safe, effective care for complaints of appropriate acuity. Data supporting those claims have been lacking, however. Lo Fu Tan, MD, MS, FCFP, FAAFP and Jillian Kreston, MBA, MEcon Citation: Tan L F, Kreston J. Cost-effective ambulatory care for emergency department avoidance. J Urgent Care Med. 2022;16(10):25-32. BACKGROUND A 2019 brief published by the United Health Group …

Urgent Care Centers Can Reduce ED Referrals for CT Scans in Mild Head Injury with Integration of Brain Activity Biomarker

Urgent message: Referrals to the ED for CT scans were reduced when urgent care providers combined clinical judgement with EEG-based structural injury biomarker results. Such reductions could relieve the burden of referrals to EDs, minimize unnecessary radiation risk, yield better patient experience, and foster to potential cost savings. Tanvir Dara MD, FACEP; Elizabeth McCarty MD; Paul Meredith MD; Robert Mooney MD; David Porzio MD; and Alvaro Zeballos MD Citation: Dara T, McCarty E, Meredith P, …

<strong>What Is the Acceptable Miss Rate for a Major Adverse Cardiac Event (MACE)? </strong><strong>A Follow-Up Survey After Release of the American College of Emergency Physicians (ACEP) Clinical Policy on Acute Coronary Syndromes</strong>

What Is the Acceptable Miss Rate for a Major Adverse Cardiac Event (MACE)? A Follow-Up Survey After Release of the American College of Emergency Physicians (ACEP) Clinical Policy on Acute Coronary Syndromes

Urgent message: Previously JUCM-published research revealed that even very low risk for a major adverse cardiac event left clinicians uncomfortable with discharging patients per 2018 ACEP guidelines. What can be learned from a follow-up study reflecting the updated version? Rebekah Samuels, OMS-III; Francesca Cocchiarale; Samidha Dutta, DO, PGY-3; Jarryd Rivera, MD; Amal Mattu, MD; Michael Pallaci, DO; Paul Jhun, MD, FAAEM; Jeff Riddell, MD; Cameron Berg, MD; and Michael Weinstock, MD. Citation: Samuels R, Cocchiarale …

Implementation of a Rapid Chest Pain Protocol in a Walk-In Clinic

Urgent message: There are no standardized guidelines for treating patients with chest pain in an urgent care clinic. Using a chest pain protocol with the Marburg Heart Score in a walk-in clinic can assist providers in assuring an appropriate level of care and support standardization in clinician decision-making for treating low-risk chest pain patients. Lorilea Johnson and Diane L. Smith Citation: Johnson L, Smith DL. Implementation of a rapid chest pain protocol in a walk-in …

Reducing Low-Acuity Preventable Emergency Room Visits by Utilizing Urgent Care Center Services via Mobile Health Unit Diversion Program

Urgent message: Urgent care centers can execute and implement innovative ideas to ameliorate overcrowded Emergency Rooms. The creation of a mobile health diversion program to transport low acuity conditions to urgent care instead of a hospital emergency department can improve population health and reduce healthcare cost; providing the opportunity to leverage value-based care by targeting the triple aim (reducing cost, increasing patient satisfaction, and improving outcomes) while freeing up the emergency medical system services. Cesar …

See You in Court: Practice and Documentation Change from a Mock Trial

Urgent message: “Mock trials” are a valuable tool to help urgent care providers offer better medical care, record more appropriate documentation, and learn about medical proceedings. Michael Weinstock, MD; Kaetha Frost, DO; Heath Jolliff, DO; Amal Mattu, MD; Seth McIntire, DO; Marc Calvert, JD; Mark Kitrick, JD; and Matt Delaney, MD Citation: Weinstock M, Frost K, Jolliff H, Mattu A, McIntire S, Calvert M, Kitrick M, Delaney M. See you in court: practice and documentation …

Use of a Quality Improvement Tool for the Evaluation of Healthcare Disparities in Urgent Care: A Case Example for Bacterial Pneumonia

Urgent message: While healthcare disparities have been studied in several healthcare settings, it is unclear whether they persist in urgent care. This study may serve as a quality improvement tool to assess whether these disparities persist in an urgent care clinic. Derrick Murcia and Lindsey Fish, MD Citation: Murcia D, Fish L. Evaluation of healthcare disparities in urgent care: a case example for bacterial pneumonia. J Urgent Care Med. 2022;16(4):23-27. Epub ahead of print September …