What is the name of your hospital/ED?
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What is the mailing address of your hospital/ED?
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In 2021, was your ED open 24 hours/day, 7 days/week?(A1a)
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Yes
No
In 2021, was your ED open 365 days per year?(A1b)
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Yes
No
If NOT open 24/7 all year in 2021, please explain:
Please indicate the total number of patient visits at your ED and the 12-month reporting period to which they apply.
Number of ED visits:(A2)
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12-month reporting period (from MM/YY to MM/YY)
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MM/YY to MM/YY
Please indicate the approximate number of ED visits by children (e.g., age < 18).
Number of Child ED visits (e.g., age < 18).(A3)
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If your ED uses another age to distinguish between children and adults (e.g., age < 21 years), and it's difficult to obtain data for age < 18, please respond above according to your ED's cut-off. (A3a)
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For EDs that regularly treat adults: Does your ED have a dedicated area for children only (e.g., dedicated beds)? (A4)
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Yes
No
Not applicable (e.g., children's hospital)
A pediatric area is any separate physical area where children are seen or sent (e.g., a designated pediatric area of the waiting room, pediatric treatment room/beds). If an area is meant for children but sometimes used for adults in case of overflow, this still counts as a pediatric area.
Do you have an identified coordinator(s) for pediatric emergency care in your ED? (A5)
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Yes
No
An identified coordinator for pediatric emergency care, or pediatric emergency care coordinator (PECC), is someone who manages pediatric care in the ED and who helps educate other ED staff on pediatric emergency care. PECC roles can vary, and some EDs refer to these individuals with different titles (e.g., Pediatric Champion).
How many identified coordinators does your ED have?(A5a)
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1
2
> 3
Please specify the type of coordinator(s): (check all that apply) (A5b)
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Physician coordinator(s)
Nurse coordinator(s)
Other (e.g. PA, administrator)
If "other" pediatric coordinator, please specify:
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How many total hours (weekly) do/does your identified coordinator(s) devote to the role?(A5c)
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< 5 hours
5 - 9.99 hours
10 - 19.99 hours
20 - 39.99 hours
> 40 hours
Does your ED utilize telehealth services to evaluate patients in your ED ?(A6)
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Yes
No
Does your ED utilize telehealth for: (check all that apply) (A6a)
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Pediatrics
Stroke/Neuro
Psychiatry
Trauma
Dermatology
Radiology
Transfer coordination
Disaster preparedness
COVID-19
Other
If "other", please specify:(A6a)
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Does your ED receive telehealth services from another facility in your health system or from an outside organization ? (A6b)
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Yes
No
Do clinicians within your ED evaluate patients within your ED using telehealth (e.g., using telehealth as electronic PPE)?(A6c)
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Yes
No
Does your ED utilize telehealth services to evaluate your own patients who are remote (e.g., in their homes or at a skilled nursing facility)?(A7)
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Yes
No
Does your total visit volume reported in A2) include these virtual ED visits? (A7a)
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Yes
No
Were these visits typically done with video? (A7b)
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Yes, 2-way video connection
Yes, 1-way video connection
No, phone connection only
Does your hospital/ED provide telehealth services out for the evaluation of patients in other EDs ?(A8)
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Yes
No
Not sure
On a typical day at 6 pm : Are there any ED patients being cared for primarily in the hallway?(A9a)
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Yes
No
On a typical day at 6 pm : Are there patients that "board" in the ED for >2hrs until an inpatient bed becomes available?(A9b)
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Yes
No
Approximate percent of patients that arrived to the ED by ambulance.(A10)
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% BY AMBULANCE
Approximate percent of ED patients that were uninsured or 'self-pay'(A11a)
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% UNINSURED
Approximate percent of ED patients participating in Medicaid.(A11b)
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% MEDICAID
Approximate percent of all ED visits that led to admission, including ICU and OBS admissions (A12)
% ADMIT
Does your ED have accreditation as a geriatric emergency department?(A13)
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Yes
No
Approximate number of ED patients over age 65.(A14)
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# OVER 65
Approximate number of critical care transfers to other facilities (i.e., transfers requiring a level of care beyond ALS - Advanced Life Support)(A15)
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# PATIENTS/YR
For 2021, please indicate the average total number of clinicians , after accounting for departures and new hires. (B1)
Number of FTE ED attending physicians:(B1a)
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Number of FTE ED nurses:(B1b)
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Number of FTE ED physician assistants:(B1c)
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Number of FTE ED nurse practitioners:(B1d)
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Percent of attending emergency physicians board-certified or board-eligible (BC/BE) by ABEM, AOBEM or ABP/Peds EM:(B2)
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% BC/BE
Is at least one Certified Emergency Nurse (CEN) on duty in the ED 24 hours/day, 7 days/week?(B3)
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Yes
No
Don't know
Is at least one attending physician (not resident) on duty in the ED 24 hours/day, 7 days/week?(exclude on-call physicians) .(B4)
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Yes
No
If NO, when a physician is not on duty in the ED , is any physician available to the ED by two-way voice communication 24 hours/day, 7 days/week:(B4a)
From within your hospital?(B4ai)
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Yes
No
From outside of your hospital?(B4aii)
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Yes
No
Are there neurology consultants available in-person to the ED?(C1)
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Yes
No
On average, how long does the consultant take to arrive?(C1a)
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0-29 min
30-59 min
> 60 min
Is the consultant available 24 hours/day, 7 days/week?(C1b)
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Yes
No
e. Time elapsed between request for patient transfer and departure from ED to an intensive care unit (e.g. on a mechanical ventilator)(C2e)
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< 30 min
30-59 min
> 60 min
NA
f. Time elapsed between request for patient transfer and departure from ED to the operating room (e.g. for emergent condition)(C2f)
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< 30 min
30-59 min
> 60 min
NA
Is alteplase (i.e., tissue plasminogen activator, tPA) available in your ED for eligible patients?(C3)
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Yes
No
Not sure
If YES, in 2021, select approximately how many stroke patients were treated with alteplase in your ED.(C3a)
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0
1-3
4+
Not sure
Does your ED have a written protocol for the management of acute stroke patients?(C4)
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Yes
No
Not sure
Approximately how many potential stroke patients were cared for in your ED in 2021?(C5)
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0
1-60
61-120
>120
Not sure
If a stroke patient requires transfer, to what hospital are patients most often sent? Please specify: (C6)
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Is endovascular therapy (i.e., mechanical thrombectomy) available in your hospital for eligible acute stroke patients with large vessel occlusion?(C7)
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Yes
No
Which of the following type of patients does your hospital typically admit? Check all that apply :(C8)
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TIA patients
Stroke patients not treated with alteplase
Stroke patients treated with alteplase
Stroke patients that require thrombectomy
Stroke patients that have an intracranial hemorrhage
None of these
Position (e.g., ED Director)
