title: Emergency Department Management of Heart Failure and COPD: A National Survey of Attitudes and Practice.
abstract: OBJECTIVE
  The Ottawa Heart Failure Risk Scale (OHFRS) and the Ottawa COPD Risk Scale (OCRS) were developed in order to estimate medical risk and to help guide disposition decisions for patients presenting to the ED with acute exacerbations of heart failure (HF) and COPD. We sought to determine physician attitudes towards these two new risk scales and to identify potential barriers to their ED implementation.
  
  
  METHODS
  Two self-administered online surveys were distributed to the Canadian Association of Emergency Physicians. The surveys each consisted of 16 questions relating to the OHFRS and OCRS. The primary outcome measures were the overall physician rating of the two risk scales. Secondary outcome measures assessed the likelihood of risk scale implementation into Canadian EDs, as well as the perceived barriers to such implementation. Descriptive statistics were used.
  
  
  RESULTS
  For the OHFRS survey, we received responses from 195 emergency physicians (35.7%). Overall, 74.4% approved of the risk scale based on a Likert rating of 4 or 5 and 66.7% believed that the risk scale would be implemented at their hospital. For the OCRS survey, we received responses from 208 emergency physicians (38.1%). Overall, 76.9% approved of the risk scale based on a Likert rating of 4 or 5 and 70.2% believed that the risk scale would be implemented at their hospital.
  
  
  CONCLUSIONS
  Canadian emergency physicians are very supportive of the new OHFRS and OCRS. We believe these risk scales will assist physicians with making safe and efficient disposition decisions and improve outcomes for patients suffering from HF and COPD.
authors.affiliation: *Faculty of Medicine,University of Ottawa,Ottawa,ON.
authors.forename: Michael K P
authors.initials: MK
authors.lastname: Hale
authors.affiliation: †Department of Emergency Medicine,University of Ottawa,Ottawa,ON.
authors.forename: Ian G
authors.initials: IG
authors.lastname: Stiell
authors.affiliation: ‡Ottawa Hospital Research Institute,Ottawa,ON.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Clement
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004635:Emergency Medicine / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004638:Emergency Treatment; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D017063:Outcome Assessment, Health Care; D010820:Physicians / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: COPD; Decision tool; Emergency medicine; Heart failure