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  Understanding Patient Uncertainty as a Driver of Emergency Department Utilization: A Concept Mapping Approach

  Angela Gerolamo, PhD, RN; Shannon Doyle, MPH; Rhea E. Powell, MD, MPH; Amanda M.B. Doty, MS; Marianna LaNoue, PhD; and Kristin L. Rising, MD, MSHP

  Background and Purpose

  • Most previous research regarding factors associated with increased risk of emergency department (ED) use has been done via retrospective review of medical records rather than obtaining patients’ perspectives.
  • Recent research identified patient uncertainty related to symptoms as a primary motivator for seeking ED care, and ongoing uncertainty at the time of ED discharge as an unmet need (Rising et al. 2015; Rising, Hudgins, Reigle, Hollander, & Carr 2016).
  • While providers have limited ability to influence many factors identified by retrospective medical record review (e.g. financial concerns), patient uncertainty can be addressed by providers directly. To do so we must first define domains of uncertainty that patients experience in order to inform targeted interventions to address patient uncertainty.
  • The objective of this research was to engage patients through group concept mapping (GCM) to conceptualize the domains of uncertainty that contribute to decisions to seek care in the ED.

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  Identifying and Addressing Hepatitis C Linkage Barriers through an Institutional Screening Process

  Madalene Zale, MPH and Priya Mammen, MD, MPH

  Aim

  This study evaluates the impact of Act 87 on HCV screening in an urban, academic hospital system with particular attention to disparate care and barriers to linkage to specialty treatment