Journal of Urgent Care Medicine

A Multicenter Study of the Rate of MACE in Chest Pain Patients with a Moderate HEART Risk Score Referred from Urgent Care for an Expedited Outpatient Cardiology Evaluation

ABSTRACT Background: The HEART Score is an effective method of risk-stratifying emergency department patients with chest pain. The rate of major adverse cardiovascular events (MACE) in patients with moderate HEART score referred from an urgent care center (UC) for an expedited outpatient cardiology evaluation is unknown. Purpose: The primary outcome of this study was to examine the rate of MACE when patients with moderate HEART score were referred for expedited outpatient cardiology follow-up after evaluation …

Chest X-Ray Findings Among Urgent Care Patients with COVID-19 Are not Affected by Patient Age or Gender: A Retrospective Cohort Study of 636 Ambulatory Patients

Joshua Russell, MD, MSc, FACEP MD; Ana Echenique, MD, DABR; Steven R. Daugherty, PhD; and Michael Weinstock, MD Abstract Background/Objective A prior study of patients presenting to urgent care (UC) centers with COVID-191 showed that only a small proportion of these ambulatory patients demonstrated significant pathology on chest x-ray (CXR). In this secondary analysis of 636 ambulatory patients with confirmed COVID-19 from greater New York City (NYC), our primary objective was to determine whether the …

The Effect—or Non-Effect—of Rapid Medical Evaluation Programs on Resident Education

Urgent message: With significant overlaps in clinical staff, patient population, and provider training between emergency medicine and urgent care, valuable insights relevant to urgent care can be gleaned from understanding the effect of incorporating provider-in-triage training into emergency medicine resident education. INTRODUCTION Crowding is a major barrier to timely and effective patient care in emergency departments. Crowding occurs when the demand for care exceeds the ability to supply it in an efficient fashion. This is …

Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee

Michael B. Weinstock, MD, Ana Echenique, MD, DABR, Joshua W. Russell, MD, MSc, FACEP, Ari Leib, MD, Jordan A. Miller, DO, David J. Cohen, MD, Stephen Waite, MD, Allen Frye, NP, and Frank A. Illuzzi, MD, FACEP Abstract Background/Objective Patients with COVID-19 commonly present to Urgent Care (UC) centers. Our primary objective was to determine what percentage of UC patients with confirmed COVID-19 had normal vs abnormal chest x-rays (CXR). Secondarily, we aim to describe …

Is Pain the Fifth Vital Sign? Higher Triage Patient-Reported Pain Score Does Not Predict Increased Admission or Transfer Rates

Urgent message: Efforts to have pain declared a “fifth vital” sign began nearly 25 years ago. Since then, several national accrediting and governmental agencies have taken up the cause of viewing pain as a distinct problem to be addressed as such. However, few data relevant to emergency and urgent care presentations exist. Mark Pruitt, DO, Ya Wen, DO, Michael Pallaci, DO, and Godwin Dogbey, PhD INTRODUCTION Traditionally, there have been four vital signs: temperature, …

A Small Step for JUCM, a Giant Leap for Urgent Care: JUCM’s latest initiative in publishing original research and leading an academic transformation as Urgent Care “comes of age”

Long before the first flowers of the new year bloom, an even earlier indicator of winter’s end manifests itself: teenagers plotting and perseverating over Spring Break plans. Partially a rite of passage and in other ways an early indicator of a youth’s future fate, much can be predicted about an adolescent’s trajectory by their choice of destination and activity during this vernal vacation. Sure, it’s not a perfect science. However, it’s safe to say that …

The Effect of PECARN Guidelines on Minor Head Injury Referrals from the Urgent Care Center to the Emergency Room

Cathleen DeLaney DNP, MSN-FNP, APRN and Kris Skalsky MSNEd, EdD, RN Abstract Background and Purpose: The focus of this project was to determine if an evidence-based educational intervention had an impact on reducing the number of pediatric head injury referrals from the urgent care center to the emergency room. The urgent care center often makes referrals of pediatric head injury patients to the ED, contributing to the overutilization and overcrowding of an already taxed system. …

Nurse-Only Visits in Urgent Care: An Analysis of Outcomes and Patient Satisfaction Relative to Traditional Care

Urgent message: As shown in an in-house study by one urgent care operator, protocol-driven, nurse-only care of specific presenting complaints may be one way to help curb healthcare spending while not compromising on quality of care or threatening patient-satisfaction scores. Kyle Coon and Brett Whyte, MD Abstract Basic healthcare costs are rising at a staggering and, it’s widely considered, unsustainable rate. As a result, lower-cost alternatives that maintain quality and satisfaction are being explored across …

Quality Improvement Report: Elevated Blood Pressure Referrals in an Urgent Care Setting to Increase Follow-Up Appointments with Primary-Care Providers

Urgent message: Urgent care providers are valued for their ability to treat nonemergent acute healthcare needs efficiently, but in so doing they are also well positioned to identify other, underlying healthcare issues such as hypertension. Introduction Heart disease is the leading cause of death in the United States and accounts for approximately 24% of all deaths.1 Many known risk factors are associated with heart disease, including high blood pressure. The Centers for Disease Control and …

A Multimodal Intervention to Reduce Antibiotic Use for Common Upper Respiratory Infections in the Urgent Care Setting

Urgent message: Upper respiratory infections (URIs) are the most common presenting complaint in urgent care. Regardless of etiology or provider specialty, antibiotics are prescribed 60% of the time for the treatment of URIs, contributing to drug-resistant respiratory organisms. Employing a multimodal intervention, the authors we were able to appreciate a modest, statistically significant decrease in the rate of antibiotic prescribing among urgent care providers. Introduction Antimicrobial resistance is arguably one of the greatest risks to …