title: Advanced units: quality measures in urgency and emergency care.
abstract: OBJECTIVE
  To evaluate, through care indicators, the quality of services rendered to patients considered urgency and emergency cases at an advanced emergency care unit.
  
  
  METHODS
  We analyzed data from managerial reports of 64,891 medical visits performed in the Emergency Care Unit of the Ibirapuera Unit at Care during the period from June 1st, 2012 through May 31st, 2013. The proposed indicators for the assessment of care were rate of death in the emergency care unit; average length of stay of patients in the unit; rate of unplanned return visits; admission rate for patients screened as level 1 according to the Emergency Severity Index; rate of non-finalized medical consultations; rate of complaints; and door-to-electrocardiogram time.
  
  
  RESULTS
  The rate of death in the emergency care unit was zero. Five of the 22 patients classified as Emergency Severity Index 1 (22.7%) arrived presenting cardiac arrest. All were treated with cardiopulmonary resuscitation and reestablishment of vital functions. The average length of stay of patients in the unit was 3 hours, 33 minutes, and 7 seconds. The rate of unscheduled return visits at the emergency care unit of the Ibirapuera unit was 13.64%. Rate of complaints was 2.8/1,000 patients seen during the period.
  
  
  CONCLUSIONS
  The model of urgency and emergency care in advanced units provides an efficient and efficaious service to patients. Both critically ill patients and those considered less complex can receive proper treatment for their needs.
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Dan Carai Maia
authors: DC
authors: Viola
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Eduardo
authors: E
authors: Cordioli
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Carlos Henrique Sartorato
authors: CH
authors: Pedrotti
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Mauro
authors: M
authors: Iervolino
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Antonio da Silva
authors: Ada S
authors: Bastos Neto
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Luis Roberto Natel de
authors: LR
authors: Almeida
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Henrique Sutton de Sousa
authors: HS
authors: Neves
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Claudio Luiz
authors: CL
authors: Lottenberg
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D016887:Cardiopulmonary Resuscitation; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004638:Emergency Treatment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014218:Triage / Q000706:statistics & numerical data
references: Acad Emerg Med. 2000 Mar;7(3):236-42
references: 10730830
references: Milbank Q. 2005;83(4):691-729
references: 16279964
references: J Emerg Nurs. 2009 Apr;35(2):105-8
references: 19285171
references: JAMA. 2010 Aug 18;304(7):763-71
references: 20716739
references: Am J Cardiol. 2006 Feb 15;97(4):437-42
references: 16461033
references: Acad Emerg Med. 2001 Feb;8(2):170-6
references: 11157294
references: Cad Saude Publica. 1994 Jan-Mar;10(1):80-91
references: 15094921
references: West J Emerg Med. 2012 Dec;13(6):463-7
references: 23359833
references: Acad Emerg Med. 2005 Jun;12(6):497-501
references: 15930399
references: Inquiry. 1985 Fall;22(3):282-92
references: 2931371
references: World Health Forum. 1995;16(2):138-44
references: 7794449
references: Pediatr Emerg Care. 2006 Aug;22(8):545-9
references: 16912620
references: Arch Pathol Lab Med. 1990 Nov;114(11):1115-8
references: 2241519
references: J Emerg Nurs. 1999 Dec;25(6):468-73
references: 10579766
references: J Emerg Med. 2012 Dec;43(6):1110-8
references: 22674038