A systematic review of triage-related interventions to improve patient flow in emergency departments

Background Overcrowding in emergency departments is a worldwide problem. A systematic literature review was undertaken to scientifically explore which interventions improve patient flow in emergency departments. Methods A systematic literature search for flow processes in emergency departments was followed by assessment of relevance and methodological quality of each individual study fulfilling the inclusion criteria. Studies were excluded if they did not present data on waiting time, length of stay, patients leaving the emergency department without being seen or other flow parameters based on a nonselected material of patients. Only studies with a control group, either in a randomized controlled trial or in an observational study with historical controls, were included. For each intervention, the level of scientific evidence was rated according to the GRADE system, launched by a WHO-supported working group. Results The interventions were grouped into streaming, fast track, team triage, point-of-care testing (performing laboratory analysis in the emergency department), and nurse-requested x-ray. Thirty-three studies, including over 800,000 patients in total, were included. Scientific evidence on the effect of fast track on waiting time, length of stay, and left without being seen was moderately strong. The effect of team triage on left without being seen was relatively strong, but the evidence for all other interventions was limited or insufficient. Conclusions Introducing fast track for patients with less severe symptoms results in shorter waiting time, shorter length of stay, and fewer patients leaving without being seen. Team triage, with a physician in the team, will probably result in shorter waiting time and shorter length of stay and most likely in fewer patients leaving without being seen. There is only limited scientific evidence that streaming of patients into different tracks, performing laboratory analysis in the emergency department or having nurses to request certain x-rays results in shorter waiting time and length of stay.

Ny förpackning för Renat Brännvin åt Vin & Sprit AB

The purpose of this degree project is to come up with a new package to Renat Brännvin for »Vin & SpritAB« and make the product more attractive on the market of bars, restaurants and hotels. The commissionhas included to decide the material of the package, whether it´s possible to manufacture the productand to make an estimation of the costs.The conditions that »Vin & Sprit AB« set up was to make the product attractive to a younger targetgroup, in this case people from 20 to 40 years old. As Renat Brännvin is considered to be a product of firstclass it´s of great importance that the package reflects the look of a premium product.At first we looked at the history of the company »Vin & Sprit AB« and Renat Brännvin. We decidedthat the package schould consist of a bottle, glasses and a device used when serving the liquor. To getinspiration before sketching we studied different kinds of bottles, glasses and serving devices. We madea lot of different sketches to start with after which we consult with Ingrid Florén – our supervisor from»Vin & Sprit AB« – agreed on one. That one we developed and we made more accurate sketches in 3DStudioMAX.At last we looked at the opportunities to produce the bottle by questioning different manufacturers. Wewanted to know the limitations to consider when making a bottle.

¿Neurodidáctica aplicada? : Una investigación sobre las aplicaciones de la neurodidáctica en la enseñanza de español y en concreto en el libro de texto Caminando 3.

This thesis analyzes the teaching material Caminando 3 from a neurodidactic perspective. The discipline of neurodidactics is young and controversial and the aim of this investigation is to present an understanding of the use of practical applications of neurodidactics in written material of education in Spanish as a second language. The methods applied are a quantitative and objective analysis of measurable aspects in Caminando 3 and a qualitative, subjective analysis which is interpreting fundamental understandings of language learning which Caminando 3 reflects in its structure and content. The results show that there are several aspects in Caminando 3 which are supported by the evidences and advices of the neurodidactic theories and simultaneously there are details in exercises and parts of the layup containing a level of repetition and prediction which are directly harmful to the process of acquisition, according to neurodidactic theories. The conclusion is that a more dynamic teaching book can be produced with guidelines that can be created using these results. Further investigations will have to measure the knowledge and success of the pupils to decide whether neurodidactics is a successful complement to traditional didactics of second language learning.