{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T20:38:04Z","timestamp":1768423084225,"version":"3.49.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T00:00:00Z","timestamp":1508198400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1481803517004134_abs1\" sec-type=\"objectives\"><jats:title>Objectives<\/jats:title><jats:p>Patients with sickle cell disease (SCD) with vaso-occlusive crises (VOC) often visit the emergency department (ED) for management of painful episodes. The primary objective of this pilot study was to evaluate the acceptability of a short-stay model for treatment of VOC in SCD outside of the ED in Toronto, Canada. Secondary objectives were to assess patient satisfaction of this model, barriers to its use and comparison of clinical outcomes to a historical control.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803517004134_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Adult SCD patients with symptoms of an uncomplicated VOC between October 2014 to July 2016 were managed according to best practice recommendations in a short-stay unit as an alternative to the local emergency room. Primary outcome of time to first analgesia, and secondary outcome of discharge rate were compared to a historical control at a local ED from 2009-2012. Satisfaction and barriers to use of the ambulatory care delivery model were assessed by patient survey.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803517004134_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Twenty-one visits were recorded at the short-stay unit during the study period. Average time to first opiate dose was 23.5 minutes in the short-stay unit compared to 100.3 minutes in the ED (p&lt;0.001). Discharge rate from the short-stay unit was 84.2%. Average patient satisfaction with this model of care was high (&gt;4\/5 on Likert scale) except for geographic accessibility (85% response rate, n=18).<\/jats:p><\/jats:sec><jats:sec id=\"S1481803517004134_abs4\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated high patient satisfaction and acceptability of a short-stay model for treatment of uncomplicated VOC in adult SCD patients in Toronto, the first of its kind in Canada.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cem.2017.413","type":"journal-article","created":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T11:19:13Z","timestamp":1508239153000},"page":"55-62","source":"Crossref","is-referenced-by-count":5,"title":["An innovative short-stay health care model for treatment of uncomplicated vaso-occlusive crisis in adult sickle cell disease patients in Canada to reduce emergency department utilization"],"prefix":"10.1007","volume":"21","author":[{"given":"Andrew","family":"Binding","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Ward","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chai","family":"Phua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronique","family":"Naessens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"O\u2019Brien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sacha","family":"Bhatia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayley","family":"Baranek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Husayn","family":"Marani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geetha","family":"Mukerji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2017,10,17]]},"reference":[{"key":"S1481803517004134_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.05123.x"},{"key":"S1481803517004134_ref4","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04193.x"},{"key":"S1481803517004134_ref14","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1182\/blood.V95.4.1130.003k03a_1130_1136","article-title":"Sickle cell anemia day hospital: an approach for the management of uncomplicated painful crises","volume":"95","author":"Benjamin","year":"2000","journal-title":"Blood"},{"key":"S1481803517004134_ref9","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1182\/blood.V122.21.1697.1697","article-title":"Cost benefit analysis of a sickle cell infusion center for the treatment of vaso-occlusive crises","volume":"122","author":"Chappidi","year":"2013","journal-title":"Blood"},{"key":"S1481803517004134_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61229-X"},{"key":"S1481803517004134_ref15","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23961"},{"key":"S1481803517004134_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2012.01330.x"},{"key":"S1481803517004134_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20336"},{"key":"S1481803517004134_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2014.11.020"},{"key":"S1481803517004134_ref7","unstructured":"NIH. Evidence-Based Management of Sickle Cell Disease. Expert Panel Report; 2014. Available at: http:\/\/www.nhlbi.nih.gov\/guidelines."},{"key":"S1481803517004134_ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199107043250103"},{"key":"S1481803517004134_ref18","unstructured":"SCDAC. Sickle Cell Disease Association of Canada; 2017. Available at: http:\/\/www.sicklecelldisease.ca\/about.php."},{"key":"S1481803517004134_ref5","unstructured":"Verhovsek M , Simpson E . CanHaem. Consensus statement on the care of patients with sickle cell disease in Canada; 2014. Available at: http:\/\/sicklecellanemia.ca\/pdf_2016\/CANHAEM.pdf."},{"key":"S1481803517004134_ref16","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21483"},{"key":"S1481803517004134_ref8","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.10757"},{"key":"S1481803517004134_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/TME.0000000000000036"},{"key":"S1481803517004134_ref17","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1999.01160.x"},{"key":"S1481803517004134_ref11","doi-asserted-by":"publisher","DOI":"10.1080\/13557858.2011.555520"}],"container-title":["CJEM"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1481803517004134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T23:40:03Z","timestamp":1609458003000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1481803517004134\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,17]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["S1481803517004134"],"URL":"https:\/\/doi.org\/10.1017\/cem.2017.413","relation":{},"ISSN":["1481-8035","1481-8043"],"issn-type":[{"value":"1481-8035","type":"print"},{"value":"1481-8043","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,17]]}}}