8/3/2023 0 Comments Ed and flow![]() ![]() ![]() With the increase of the aging population, the worldwide prevalence of ED has been predicted to reach 322 million cases by the year 2025, making it a major health problem ( 3, 4). New methods of long-term dynamic detection are needed.Įrectile dysfunction (ED), as defined by the National Institutes of Health Consensus Panel, refers to the situation of inability to achieve and/or maintain penile erection sufficient for satisfactory sexual performance, which is divided into psychological, organic and mixed based on the etiology ( 1, 2). Although various existing examinations are widely used for the evaluation of vascular ED, they still have some shortcomings, such as invasiveness, contingency, high false positive (negative) rate. Endo-peripheral arterial tonometry (PAT) has also been used to detect vascular endothelial function. While for the diagnosis of venous ED, shear wave elastography, dynamic infusion cavernosometry and cavernosography are more accurate. For the diagnosis of arterial ED, color duplex Doppler ultrasound, selective penile angiography, magnetic resonance imaging, and computed tomography are more commonly used. Intra-cavernous injection of vasoactive drugs is the earliest method used in the diagnosis of vascular ED and is a basic test. According to the different application scenarios, the main methods for the diagnosis of vascular ED are divided into four categories. This study retrospectively reviewed all available literature focusing on the diagnosis of vascular ED through a systematic PubMed and EMBASE search. At present, there are many approaches to diagnose ED, but each method has its advantages and limitations. They developed recommendations for process change, prioritizing change initiatives which could make the greatest impact.Vascular erectile dysfunction (ED) is closely related to cardiovascular events, and early diagnosis of vascular ED may be helpful to predict the occurrence of cardiovascular events and improve prognosis. The work team completed a deep dive review into each area identified in the assessment and leveraged the data analysis and stakeholder input gathered earlier. The task was to collaboratively agree to an action plan to improve the ED walkout and length of stay rates. Implement standard work processes to addresses the frequent capacity issues in the EDĪ PI work team was organized, led by Philips consultants and included SMMC physicians, administrative leaders, ED staff, and ancillary staff.Examine utilization of existing space to optimize workflow.Re-educate staff on the ESI 5-level triage system.Revise front-end processes to include the intake and triage processes.Several areas were identified as needing improvement, including actions to: The consultants conducted interviews with administrators, departmental leaders, and staff, and spent considerable time observing ED patient flow, staff workflow, departmental processes, and communication. The performance assessment included a thorough analysis of data collected for volume, arrival patterns, staffing patterns, ESI level distribution, ED billing visit level distribution, disposition breakdown, and length of stay. The third consultant supported SMMC during these improvement initiatives and the two other consultants were asked to continue in the interim roles for the long-term. Adding the PI program allowed the interim leaders to focus on team management while supporting the operational efficiency process changes.Ī third consultant joined to focus on leading teams towards improving key performance indicators. They quickly became valuable leaders of the team.Ī comprehensive assessment of key operational metrics was completed and a performance improvement (PI) engagement was recommended. Leadership responsibilities included staff communications/relationships/support, hiring vacant staff positions and resource planning, staff development and training, assisting with conflict resolution, team mentoring, and more. Philips consultants joined SMMC as Interim ED Manager and ED Director, focused on day-to-day operational and staff management. An innovative approach to ED performance improvement
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