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 …

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 …

<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 …

COVID-19 Testing Pattern in a Suburban Pediatric Urgent Care Center

Urgent message: Though not considered as at “at risk” for severe disease with COVID-19, children have suffered significant disruptions to educational and personal activities throughout the pandemic. Recognizing urgent care’s role in testing for the virus could show benefit for families and urgent care centers alike. Rita P. Nunag, MD; Francesca M. Darquea, MD; Claire Loiselle; and Magdy W. Attia, MD Citation: Nunag RP, Darquea FM, Loiselle C, Attia MW. COVID-19 testing pattern in a …

Assessing the Rate at which Pacemaker and Defibrillator Patients Present to the Emergency Room with their Manufacturer ID Card: A Cross Sectional Study

Urgent message: Care can be delayed if an urgent care or emergency clinician attempts to interrogate the CIED of a patient who does not know their device manufacturer and does not carry their ID card. This scenario illustrates the importance of patient education in care centers, such as the emergency department and urgent care. Tinh M. Le; James F. Neuenschwander, MD, FACEP; Mary Jones, DNP; Ankur Parekh; Hana Le; Kaitlyn Cedoz; and Clark Daugherty ABSTRACT …