Keywords: boarding, administration, crowding (PubMed Search)
A recently published study of ED APPs, residents, attendings, and nurses attempted to assess clinician's perspectives on how ED boarding impacts ED staff and patients. Authors performed a survey followed by focus group sessions to obtain qualitative insignts from participants.
All respondents associated boarding with feelings of burnout and self-reported poor satisfaction with communication and the process of boarding care.
Several key themes emerged which are outlined below:
This publication highlights the negative workforce and patient safety effects of ED boarding. It amplifies the voices of our colleagues who work towards change to improve both the health of our wrokforce as well as that of our patients and the communities that we serve.
Loke D, et al. Clinicians’ Insights on Emergency Department Boarding: An Explanatory Mixed Methods Study Evaluating Patient Care and Clinician Well-Being. The Joint Commission Journal on Quality and Patient Safety 2023; 000:1-8.
Keywords: Workforce, Diversity, Under-represented minorities (PubMed Search)
Physician Workforce Diversity in EM
Health inequities along racial, ethnic, and socioeconomic lines are a brutal reality of the current state of health care in the US. One way to attempt to address these inequities is to make a concerted effort to diversify our physician workforce. As authors have noted, “Having physicians from diverse backgrounds as colleagues and role models can promote understanding and tolerance in nonminority physicians, ultimately improving medical care for patients who are part of these racial and ethnic groups. Increasing the population of underrepresented minority (URM) physicians in the workforce also directly improves health care for medically underserved populations from all racial and ethnic backgrounds, as studies have shown that physicians from URM backgrounds are more likely to work with these patients.”
Administrators are often tasked with the difficult job of creating a cohesive group of emergency physicians to meet the needs of the community they serve. Strategies to diversify that workforce would benefit from a multi-level approach, including the following:
Small steps can create big changes.
Keywords: age, attrition, gender, workforce (PubMed Search)
In a recent study of emergency physicians (EPs) who left the workforce between 2013 and 2020, authors sought to investigate their age and number of years since residency graduation for males and females.
A total of 25,839 (70.2%) male and 10,954 (29.8%) female EPs were included.
Female gender (adjusted odds ratio 2.30) was significantly associated with attrition from the workforce.
Of those who left the workforce, the median number of years after residency that males left was 17.5, as compared with only 10.5 years for females.
Furthermore, among those who exhibited attrition, one in 13 males and one in 10 females exited clinical practice within 5 years of residency graduation.
As authors emphasize, these data identify widespread gender-based disparities regarding EM workforce attrition that are critical to address to ensure stability, longevity, and diversity in the EP workforce.
Gettel CJ, Courtney DM, Agrawal P, et al. Emergency medicine physician workforce attrition
differences by age and gender. Acad Emerg Med. 2023;00:1- 9. doi:10.1111/acem.14764
Keywords: patient experience, clinician wellbeing (PubMed Search)
Clinician Well-Being and the Patient Experience
Did you know that most patient experience responses are overwhelmingly positive? Rather than focusing all our attention on the bad, let’s focus on the good to promote clinician well-being. See below for a few key points from a recent study on this:
Consider emphasizing positive patient experiences when providing feedback to emergency physicians. It will promote clinician well-being and help improve performance in your practice.
Dudley J and Lee TH. Patient Experience and Clinician Well-Being Aren’t Mutually Exclusive. Harvard Business Review. Published online at hbr.org, July 18, 2022.