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2. A near real-time interactive dashboard for monitoring and anticipating demands in emergency care in the Île-de-France region (France).

Author

Hanf, Matthieu, Salle, Léopoldine, Mas, Charline, Ghribi, Saif Eddine, Huitorel, Mathias, Mebarki, Nabia, Larid, Sonia, Mazué, Jane-Lore, and Wargon, Mathias

Abstract

Objective To allow health professionals to monitor and anticipate demands for emergency care in the Île-de-France region of France. Materials and Methods Data from emergency departments and emergency medical services are automatically processed on a daily basis and visualized through an interactive online dashboard. Forecasting methods are used to provide 7 days predictions. Results The dashboard displays data at regional and departmental levels or for 5 different age categories. It features summary statistics, historical values, predictions, comparisons to previous years, and monitoring of common reasons for care and outcomes. Discussion A large number of health professionals have already requested access to the dashboard (n = 606). Although the quality of data transmitted may vary slightly, the dashboard has already helped improve health situational awareness and anticipation. Conclusions The high access demand to the dashboard demonstrates the operational usefulness of real-time visualization of multisource data coupled with advanced analytics. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial

Author

Freund, Yonathan, Cachanado, Marine, Aubry, Adeline, Orsini, Charlotte, Raynal, Pierre-Alexis, Féral-Pierssens, Anne-Laure, Charpentier, Sandrine, Dumas, Florence, Baarir, Nacera, Truchot, Jennifer, Desmettre, Thibaut, Tazarourte, Karim, Beaune, Sebastien, Leleu, Agathe, Khellaf, Mehdi, Wargon, Mathias, Bloom, Ben, Rousseau, Alexandra, Simon, Tabassome, and Riou, Bruno

Published
2018
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8. Analysis of the Feasibility of a Vaccination Campaign against Influenza Epidemic and COVID-19 Pandemic in French Emergency Departments: A National Survey

Author

Ghazali, Daniel Aiham, primary, Choquet, Christophe, additional, Bouzid, Donia, additional, Colosi, Luisa, additional, Ben Hammouda, Arsalene, additional, Wargon, Mathias, additional, Gay, Matthieu, additional, Vaittinada Ayar, Prabakar, additional, Douay, Bendecite, additional, Revue, Eric, additional, Soulat, Louis, additional, Hellmann, Romain, additional, and Casalino, Enrique, additional

Published
2021
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11. COVID-19 Preparedness Among Emergency Departments: A Cross-Sectional Study in France.

Author

Casalino, Enrique, Bouzid, Donia, Ben Hammouda, Arsalene, Wargon, Mathias, Curac, Sonja, Hellmann, Romain, Choquet, Christophe, and Ghazali, Daniel Aiham

Subjects
EMERGENCY management, COVID-19, PUBLIC health
Abstract

Objectives: The aim of this study was to evaluate hospital and emergency department (ED) preparedness in France facing the coronavirus disease 2019 (COVID-19) rapid growth epidemic-phase, and to determine the link between preparedness and responsiveness. Methods: In this cross-sectional study, from March 7 to March 11, 2020, all heads of ED departments in France were contacted to answer an electronic survey, including 23 questions. Quality, Organization, Training, Resources, Management, Interoperability, and Responsiveness were evaluated by calculating scores (10 points). Multivariate analysis of variance was used to compare scores. Spearman's correlation coefficient and multifaceted regression analysis were performed between Responsiveness and dimensions scores. Results: A total of 287 of 636 French EDs were included (45.1%). Calculated scores showed (median): Quality 5.38; Organization 6.4; Training 4.6; Resources 4.13; Management 2.38; Interoperability 4.0; Responsiveness 6.25; seasonal influenza score was 5. Significant differences between scores as a function of hospital and ED main characteristics were found. Furthermore, we found significant correlations (P < 0.01) between Responsiveness and all preparedness dimensions. Organization (adjusted-R2 0.2897), Management (aR2 0.321), and Interoperability (aR2 0.422) were significantly associated with Responsiveness. Conclusions: Preparedness in all its dimensions is low, indicating vulnerability. Preparedness and responsiveness face a certain and ongoing risk are close linked, and that Organizational, Management, and Interoperability dimensions are main determinants. [ABSTRACT FROM AUTHOR]

Published
2022
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14. Cardiopulmonary Resuscitation in Adults Over 80: Outcome and the Perception of Appropriateness by Clinicians

Author

Druwe, Patrick, Benoit, Dominique D., Monsieurs, Koen, Gagg, James, Nakahara, Shinji, Alpert, Evan Avraham, van Schuppen, Hans, Elo, Gabor, Huybrechts, Sofie A., Mpotos, Nicolas, Joly, Luc-Marie, Xanthos, Theodoros, Roessler, Markus, Paal, Peter, Cocchi, Michael N., Bjorshol, Conrad, Nurmi, Jouni, Salmeron, Pascual Pinera, Owczuk, Radoslaw, Svavarsdottir, Hildigunnur, Cimpoesu, Diana, Raffay, Violetta, Pachys, Gal, De Paepe, Peter, Piers, Ruth, Hill, Michael, Spottl, Peter, Gemes, Geza, Grander, Wilhelm, Rugg, Christopher, Likar, Rudolf, von Lutterotti, Theresa, Mitterndorfer, Walter, Baumgartner, Karl, Trimmel, Helmut, Sator, Florian, Pogatschnigg, Michael, Rastner, Verena, Luger, Markus, Schinnerl, Adi, Fleischmann, Wolfgang, Predl, Barbara, Aigner, Patrick, Adler, Rene, Huybrechts, Sofie, Verbeeck, Kris, Van den Broeck, Jan, Vandereyken, Frederik, Leach, Robert, De Kock, Kurt, Raveel, Geert, Van Damme, Erwin, Riahi, Sami, Meuris, David, Engels, Jorge, Fabien, Guerisse, Vranckx, Marc, Kreps, Bernard, Imbo, Filip, Vantroyen, Barbara, Maules, Yves, Sabbe, Marc, Jensen, Peter, Tabrizi, Nima Hosseinpour, Vanelderen, Pascal, Beaune, Sebastien, Ageron, Francois-Xavier, Wargon, Mathias, Roupie, Eric, Gosse, Pierre, Faour, Ali, Duncan, Gregory, Dumas, Florence, Wiel, Eric, Fort, Pierre Arnaud, Jacquin, Laurent, Duval, Arnaud Depil, Boishardy, Fabrice, Freund, Yonathan, Broche, Claire, Giolito, Didier, Herve, Thierry, Rozenberg, Alain, Jardel, Benoit, Flemming, Andreas, Wiegand, Nicolai, Hagemann, Wolfgang, Mueller, Thorsten, Selis, Melanie, Deussen, Marc, Callies, Andreas, Schiffner, Jens, Strickmann, Bernd, Schwille, Ulrich, Christenhusz, Arjan, Weijschede, Frits, Juffermans, Erwin, Nienhuis, Angelique, Breeman, Wim, Landman, Esther, Vrusch, Rob, Wouters, Sven, Winkel, Steven, den Boer, Eugene, Ketelaar, Aart, Hutten, Albert, Fokker, Katinka, van Ree, Karin, Mulder, Peter Jan, Lambregts, Rini, Deasy, Conor, Gilligan, Peadar, Breslin, Tomas, Kennedy, Una, O'Connor, Gabrielle, Doyle, Mark, Fallon, Hilary, McDaid, Fiona, Yeung, Davy, Benger, Jonathan, Stacey, Victoria, Dorrian, Susan, Haig, Stephen, Byers, Sonia, McLauchlan, Chris, Watson, David, Robinson, Maria, Kendall, Jason, Whitfield, Richard, Foster, Theresa, Truhla, Anatolij, Skulec, Roman, Smrzova, Eva, Lejsek, Jan, Gregor, Roman, Sin, Robin, Kubalova, Jana, Kratochvil, Jaroslav, Zika, Jiri, Fiala, Hynek, Koci, Jaromir, Jelen, Stanislav, Galgoczy, Peter, Szabados, Gyorgy, Temesvari, Peter, Kalman, Attila, Zubek, Laszlo, Kovacs, Eniko, Kiss, Domonkos, Valent, Mihaly, Kanizsai, Peter, Wilanowski, Tomasz, Zemojtel, Lukasz, Dubieniecki, Maciej, Ingielewicz, Anna, Wozniak, Piotr, Galazkowski, Robert, Sirbu, Fernando, Milenkovic, Dusan, Trenkler, Stefan, Dobias, Viliam, Ilavsky, Michal, Bajerovska, Lubica, Kubova, Dana, Patras, Juraj, Ioannides, Marios, Georgiou, Marios, Venetsanos, Philipos, Adamos, Georgios, Barouxis, Dimitrios, Karlis, Georgios, Chalkias, Athanasios, Lecinena, Maria Angelez, Suero, Coral, Herrero, Pablo, Sanchez, Miquel, del Castillo, Juan Gonzalez, del Arco, Carmen, Ezponda, Francisco, Llorens, Pere, Boque, Carmen, Millan, Javier, Fernandez, Pablo, Mozota, Julian, Povar, Javier, Juarez, Ricardo, Puiguriguer, Jordi, Navarro, Carmen, Aguero, Clotilde, Gorjon, Esther, Monteagudo, Tania, Saenz, Fernando, Gomez, Ignacio, Picabea, Alberto, Espinosa, Salvador, Palviainen, Jan-Erik, Tavasti, Juhani, Hallikainen, Juhana, Suonpera, Ville, Suonsyrja, Timo, Kaartinen, Johanna, Hoppu, Sanna, Carrasco, Anton Berg, Jonsdottir, Hrafnhildur Lilja, Palsson, Njall, Petursdottir, Sigrun, Palmadottir, Helga, Oskarsson, Jon Palmi, Olafsson, Oddur, Acterberg, Joseph, Blindheim-Rodal, Lillyanne, Hauge, Martin, Ytreland, Sven, Steen-Hansen, Jon Erik, Wilson, Thomas, Naess, Kristoffer, Kurland, Lisa, Malmquist, Pia, Forberg, Jakob Lundager, Djarv, Therese, Fuenzalida, Pablo Aguilera, Lara, Barbara, Zalut, Todd, Weiser, Giora, Strugo, Refael, Jaffe, Eli, Krispil, David, Schwartz, Dagan, Raitter, Ravit, Zimmerman, Deena, Tzadik, Efrat, Markowitz, Samuel, Wacht, Oren, Inagaki, Nobuhiro, Hanada, Hiroyuki, Takahoko, Ken-ichi, Negishi, Masatoshi, Matsushima, Hisao, Kano, Hideki, Koyama, Teppei, Takegami, Tetsuro, Yanagawa, Youichi, Harada, Masahiro, Yasuda, Mitsuhiro, Inaba, Kensuke, Sakamoto, Yuichiro, Yamashita, Hisashi, Honma, Masato, Tanabe, Seizan, Nachi, Sho, Nodagashira, Tatsuya, Matoh, Fumitaka, Takahashi, Tomohiro, Sode, Yoshihisa, Liu, Keibun, Yonekawa, Chikara, Inoue, Teruhiro, Sumi, Tatsunori, Kan'o, Tomomichi, Shoko, Tomohisa, Ishikura, Ken, Suzuki, Shuichi, Kishimoto, Masafumi, Katsuhara, Kazuhiro, Yumoto, Tetsuya, Nishimura, Tetsuro, Yamada, Tomoki, Otani, Takayuki, Yoshida, Kosuke, Nakamura, Motohiro, Uemura, Shuji, Umezawa, Kougaku, Nakamura, Shunsuke, Sugino, Takahiko, Tsunoyama, Taichiro, Endo, Tomoyuki, Nishida, Masamichi, Yagi, Masaharu, Fujita, Motoki, Arends, Jack, Buonadonna, Michael, Narikawa, Kenji, Sakamoto, Tetsuya, Callaway, Clifton, Goldberg, Scott, Wilcox, Susan, Gaieski, David, Sanko, Stephen, Kang, Tarina, HUS Emergency Medicine and Services, Staff Services, Clinicum, Department of Diagnostics and Therapeutics, University of Helsinki, Kimmo Kontula Research Group, Graduate School, ACS - Diabetes & metabolism, APH - Quality of Care, ACS - Heart failure & arrhythmias, ACS - Amsterdam Cardiovascular Sciences, Anesthesiology, and REAPPROPRIATE Study Grp

Subjects
Male, medicine.medical_specialty, Resuscitation, media_common.quotation_subject, medicine.medical_treatment, education, 030204 cardiovascular system & hematology, Out of hospital cardiac arrest, 03 medical and health sciences, 0302 clinical medicine, AGE, Older patients, Japan, Perception, Physicians, Hospital discharge, Medicine, Humans, Cardiopulmonary resuscitation, media_common, Resuscitation Orders, Aged, 80 and over, business.industry, OF-LIFE, HOSPITAL CARDIAC-ARREST, 030208 emergency & critical care medicine, CARE, inappropriate care, Cardiopulmonary Resuscitation, United States, 3. Good health, Nursing Homes, Europe, Cross-Sectional Studies, 3121 General medicine, internal medicine and other clinical medicine, Emergency medicine, SURVIVAL, Female, Human medicine, Geriatrics and Gerontology, adults 80 and older, business, Nursing homes, ETHICS, Out-of-Hospital Cardiac Arrest
Abstract

OBJECTIVES: To determine the prevalence of clinician perception of inappropriate cardiopulmonary resuscitation (CPR) regarding the last out‐of‐hospital cardiac arrest (OHCA) encountered in an adult 80 years or older and its relationship to patient outcome. DESIGN: Subanalysis of an international multicenter cross‐sectional survey (REAPPROPRIATE). SETTING: Out‐of‐hospital CPR attempts registered in Europe, Israel, Japan, and the United States in adults 80 years or older. PARTICIPANTS: A total of 611 clinicians of whom 176 (28.8%) were doctors, 123 (20.1%) were nurses, and 312 (51.1%) were emergency medical technicians/paramedics. RESULTS AND MEASUREMENTS: The last CPR attempt among patients 80 years or older was perceived as appropriate by 320 (52.4%) of the clinicians; 178 (29.1%) were uncertain about the appropriateness, and 113 (18.5%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the “appropriate” subgroup was 8 of 265 (3.0%), 1 of 164 (.6%) in the “uncertain” subgroup, and 2 of 107 (1.9%) in the “inappropriate” subgroup (P = .23); 503 of 564 (89.2%) CPR attempts involved non‐shockable rhythms. CPR attempts in nursing homes accounted for 124 of 590 (21.0%) of the patients and were perceived as appropriate by 44 (35.5%) of the clinicians; 45 (36.3%) were uncertain about the appropriateness; and 35 (28.2%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the nursing home patients was 0 of 107 (0%); 104 of 111 (93.7%) CPR attempts involved non‐shockable rhythms. Overall, 36 of 543 (6.6%) CPR attempts were undertaken despite a known written do not attempt resuscitation decision; 14 of 36 (38.9%) clinicians considered this appropriate, 9 of 36 (25.0%) were uncertain about its appropriateness, and 13 of 36 (36.1%) considered this inappropriate. CONCLUSION: Our findings show that despite generally poor outcomes for older patients undergoing CPR, many emergency clinicians do not consider these attempts at resuscitation to be inappropriate. A professional and societal debate is urgently needed to ensure that first we do not harm older patients by futile CPR attempts. J Am Geriatr Soc 68:39–45, 2019

Published
2019

15. A comprehensive simulation modeling of an emergency department: A case study for simulation optimization of staffing levels

Author

Ghanes, Karim, Jouini, Oualid, Jemai, Zied, Wargon, Mathias, Koole, Ger, Hellmann, Romain, Thomas, Valérie, Laboratoire Génie Industriel - EA 2606 (LGI), CentraleSupélec, Ecole Nationale d'Ingénieurs de Tunis (ENIT), Université de Tunis El Manar (UTM), Hôpital Saint Camille, Vrije universiteit = Free university of Amsterdam [Amsterdam] (VU), Agence Régionale de la Santé (ARS), IEEE, and VU University Amsterdam

Subjects
0209 industrial biotechnology, 03 medical and health sciences, 020901 industrial engineering & automation, 0302 clinical medicine, 030208 emergency & critical care medicine, [INFO.INFO-RO]Computer Science [cs]/Operations Research [cs.RO], 02 engineering and technology, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation
Abstract

International audience; We propose a Discrete Event Simulation (DES) model for an emergency department (ED). The model is developed in close collaboration with the French hospital Saint Camille, and is validated using real data. The objective of this model is to help ED managers better understand the behavior of the system and to improve the ED operations performance. The most essential features of an ED are considered in the model. A case study is conducted in order to allow decision makers select the most relevant investment in the human staffing budget. A simulation-based optimization algorithm is adopted to minimize the average Length of Stay (LOS) under a budget constraint. We conduct a sensitivity analysis on the optimal average LOS as a function of the staffing budget, and derive useful recommendations to managers on how the budget can impact the performance of the system.

Published
2014

18. Unscheduled-Return-Visits after an Emergency Department (ED) Attendance and Clinical Link between Both Visits in Patients Aged 75 Years and Over: A Prospective Observational Study

Author

Pereira, Laurent, primary, Choquet, Christophe, additional, Perozziello, Anne, additional, Wargon, Mathias, additional, Juillien, Gaelle, additional, Colosi, Luisa, additional, Hellmann, Romain, additional, Ranaivoson, Michel, additional, and Casalino, Enrique, additional

Published
2015
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20. Predictive factors for longer length of stay in an emergency department: a prospective multicentre study evaluating the impact of age, patient's clinical acuity and complexity, and care pathways

Author

Casalino, Enrique, primary, Wargon, Mathias, additional, Peroziello, Anne, additional, Choquet, Christophe, additional, Leroy, Christophe, additional, Beaune, Sebastien, additional, Pereira, Laurent, additional, Bernard, Julien, additional, and Buzzi, Jean-Claude, additional

Published
2013
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21. Predictive variables of an emergency department quality and performance indicator: a 1-year prospective, observational, cohort study evaluating hospital and emergency census variables and emergency department time interval measurements

Author

Casalino, Enrique, primary, Choquet, Christophe, additional, Bernard, Julien, additional, Debit, Abigael, additional, Doumenc, Benoit, additional, Berthoumieu, Audrey, additional, and Wargon, Mathias, additional

Published
2012
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23. What predicts initiation of osteoporosis treatment after fractures: education organisation or patients' characteristics?

Author

Semerano L, Guillot X, Rossini M, Avice E, Bégué T, Wargon M, Boissier MC, and Saidenberg-Kermanac'h N

Subjects
Aged, Demography, Female, Humans, Longitudinal Studies, Male, Osteoporosis complications, Osteoporosis diagnosis, Patient Care Team, Patient Compliance, Continuity of Patient Care organization & administration, Fractures, Spontaneous etiology, Osteoporosis therapy, Patient Acceptance of Health Care, Patient Education as Topic
Abstract

Objectives: Fracture events due to osteoporosis (OP) are a major health burden in an ageing population. Their diagnosis and treatment provides the opportunity to prevent further fractures. However, the identification and treatment of underlying OP is often unsatisfactory. This longitudinal observational study, attempts to understand the barriers hindering OP treatment initiation in patients entering our hospital for fragility fracture., Methods: 349 patients with fragility fracture underwent OP education (interview with a trained nurse) and were offered further OP care either with their general physician (or private rheumatologist) or at the hospital. In the latter case, the patients were given an appointment for OP-centred investigation and consultation. Six months after the fracture they were contacted to know whether they had been investigated and had started a treatment for OP (outcome). The factors predicting the outcome were analysed., Results: The organisation of further OP care at the hospital yielded the highest probability of being treated (OR 118.09; 95%CI [13.93-1000.92]), while patient's education on OP had a slighter effect (OR 4.74; 95%CI [2.15-10.44]). A low social status was the strongest patient-related negative predictor of further treatment (OR 0.22 [95%CI 0.09-0.47])., Conclusions: The organisation of patients' OP care is the strongest determinant of OP investigation and treatment after fracture, and this aspect should be considered when attempting to increase OP care in everyday practice. Patients having a low social status are less likely to be investigated and treated, and additional efforts to properly organise their care are warranted.

Published
2011

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