CJEM Articles: Michael Bullard

Displaying 1-8 of 8 results

  • Development of the Canadian Emergency Department Diagnosis Shortlist
    July 2010 12 4
    Antoinette Colacone, Bernard Unger, Eddy Lang, Eli Segal, Eric Grafstein, Jean François Boivin, Marc Afilalo, Michael Bullard, Michael Schull, Nathalie Soucy, Xiaoqing Xue

    Objective: Managers of emergency departments (EDs), governments and researchers would benefit from reliable data sets that characterize use of EDs. Although Canadian ED lists for chief complaints and triage acuity exist, no such list exists for diagnosis classification. This study was aimed at developing a standardized Canadian Emergency Department Diagnosis Shortlist (CED-DxS), as a subset of the full International Classification of Diseases, 10th revision, with Canadian Enhancement (ICD-10-CA).

    Methods: Emergency physicians from across Canada participated in the revision of the ICD-10-CA through 2 rounds of the modified Delphi method. We randomly assigned chapters from the ICD-10-CA (approximately 3000 diagnoses) to reviewers, who rated the importance of including each diagnosis in the ED­specific diagnosis list. If 80% or more of the reviewers agreed on the importance of a diagnosis, it was retained for the final revision. The retained diagnoses were further aggregated and adjusted, thus creating the CED-DxS.

    Results: Of the 83 reviewers, 76% were emergency medicine (EM)–trained physicians with an average of 12 years of experience in EM, and 92% were affiliated with a university teaching hospital. The modified Delphi process and further adjustments resulted in the creation of the CED-DxS, containing 837 items. The chapter with the largest number of retained diagnoses was injury and poisoning (n = 292), followed by gastrointestinal (n = 59), musculoskeletal (n = 55) and infectious disease (n = 42). Chapters with the lowest number retained were neoplasm (n = 18) and pregnancy (n = 12).

    Conclusion: We report the creation of the uniform CED-DxS, tailored for Canadian EDs. The addition of ED diagnoses to existing standardized parameters for the ED will contribute to homogeneity of data across the country.

  • Data collection on patients in emergency departments in Canada
    November 2006 8 6
    Brian H. Rowe, Douglas Sinclair, Kenneth Bond, Maria B. Ospina, Michael Bullard, Michael Schull, Sandra Blitz

    Objective: Relatively little is known about the ability of Canadian emergency departments (EDs) and the federal, provincial and territorial governments to quantify ED activity. The objectives of this study were to determine the use of electronic patient data in Canadian EDs, the accessibility of provincial data on ED visits, and to identify the data elements and current methods of ED information system (EDIS) data collection nationally.

    Methods: Surveys were conducted of the following 3 groups: 1) all ED directors of Canadian hospitals located in communities of >10 000 people, 2) all electronic EDIS vendors, and 3) representatives from the ministries of health from 13 provincial and territorial jurisdictions who had knowledge of ED data collection.

    Results: Of the 243 ED directors contacted, 158 completed the survey (65% response rate) and 39% of those reported using an electronic EDIS. All 11 EDIS vendor representatives responded. Most of the vendors provide a similar package of basic EDIS options, with add-on features. All 13 provincial or territorial government representatives completed the survey. Nine (69%) provinces and territories collect ED data, however the source of this information varies. Five provinces and territories collect triage data, and 3 have a comprehensive, jurisdiction-wide, population-based ED database. Thirty-nine percent of EDs in larger Canadian communities track patients using electronic methods. A variety of EDIS vendor options are available and used in Canada.

    Conclusion: The wide variation in methods and in data collected presents serious barriers to meaningful comparison of ED services across the country. It is little wonder that the majority of information regarding ED overcrowding in Canada is anecdotal, when the collection of this critical health information is so variable. There is an urgent need to place the collection of ED information on the provincial and national agenda and to ensure that the collection of this information consistent, comprehensive and mandatory.

  • Révision de L'échelle canadienne de triage et de gravité pour les départements d'urgence : Guide d'implantation
    January 2005 7 1
    Eric Grafstein, Michael Bullard, Michael Murray
  • Revisions to the Canadian Emergency Department Triage and Acuity Scale Implementation Guidelines
    November 2004 6 6
    Eric Grafstein, Michael Bullard, Michael Murray
  • Canadian Emergency Department Information System (CEDIS) Presenting Complaint List (Version 1.0)
    January 2003 5 1
    Bernard Unger, Eric Grafstein, Grant Innes, Michael Bullard
  • The impact of parenteral opioid analgesics on sonographic and clinical diagnostic accuracy for suspected acute appendicitis
    October 1999 1 3
    Bruce Campana, Michael Bullard, Sunil Sookram
  • Introduction
    April 1999 1 1
    David Rhine, Michael Bullard

    University of Alberta, Edmonton, Alta.; King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

  • Chest pain observation units for patients with unstable angina
    April 1999 1 1
    Erica Rabin, Michael Bullard