Category: Administration
Keywords: artificial intelligence, emergency department, emergency practice, machine learning (PubMed Search)
Posted: 11/27/2024 by Mercedes Torres, MD
Click here to contact Mercedes Torres, MD
Gooble, gooble,… gulp, some food for thought on the eve of Thanksgiving.
The development of artificial intelligence (AI) in emergency medicine is well under way. The schematic below and accompanying reference presents the anticipated stages in the process of AI development, including important features, considerations, and challenges as we move towards increased integration of AI in our practice of EM.
Petrella, R. The AI Future of Emergency Medicine. Ann Emerg Med. 2024;84:139-153. https://doi.org/10.1016/j.annemergmed.2024.01.031
Category: Administration
Keywords: design, workspace, handoff, interruptions, collaboration (PubMed Search)
Posted: 9/21/2024 by Mercedes Torres, MD
(Updated: 9/25/2024)
Click here to contact Mercedes Torres, MD
Joshi R, Joseph A, Ossmann M, et al. Emergency Physicians’ Workstation Design: An Observational Study of Interruptions and Perception of Collaboration During Shift-End Handoffs. HERD: Health Environments Research & Design Journal. 2021;14(4):174-193. doi:10.1177/19375867211001379
Category: Infectious Disease
Keywords: Mpox, monkeypox, outbreak, democratic republic of congo (PubMed Search)
Posted: 8/25/2024 by Mercedes Torres, MD
Click here to contact Mercedes Torres, MD
Background:
What’s new?
Who is at risk?
Patients with epidemiologic characteristics and lesions or other signs and symptoms consistent with mpox. This includes anyone with travel to DRC or any of its neighboring countries (ROC, CAR, Rwanda, Burundi, Uganda, Zambia, Angola, Tanzania, and South Sudan) in the previous 21 days.
What to look for?
(Above photos from https://www.cdc.gov/poxvirus/mpox/clinicians/clinical-recognition.html)
What to do?
If mpox is suspected in a patient:
Duwell M. Mpox Clinician Letter. Maryland Department of Health. August 19, 2024.
Mpox Caused by Human-to-Human Transmission of Monkeypox Virus in the Democratic Republic of the Congo with Spread to Neighboring Countries. US Centers for Disease Control and Prevention. CDC Health Alert Network, August 7, 2024, 3:15 PM ET, Accessed at https://emergency.cdc.gov/han/2024/han00513.asp# on August 25, 2024.
Mpox. US Centers for Disease Control and Prevention. https://www.cdc.gov/poxvirus/mpox/index.html, Accessed on August 25, 2024.
Category: Administration
Keywords: Administration, Meetings, Workforce satisfaction (PubMed Search)
Posted: 7/24/2024 by Mercedes Torres, MD
Click here to contact Mercedes Torres, MD
Participation in meetings is an expected part of most (if not all) of our jobs. How many of these meetings are necessary? Could some of the “work” of meetings be accomplished with a few emails or other asynchronous forms of communication? Are meetings cluttering your schedule and making it impossible to get any real work done?
Some answers to these questions are offered in a Harvard Business Review article from March 2022.
Key points include:
Advantages to fewer meetings:
Authors recommend holding meetings only when “absolutely” necessary. That typically includes:
Laker B, Pereira V, Malik A, and Soga L. Meeting Management: Dear Manager, You’re Holding Too Many Meetings. Harvard Business Review. March 9, 2022.
Category: Administration
Keywords: Specialty ED, Geriatric ED, Oncologic ED (PubMed Search)
Posted: 5/21/2024 by Mercedes Torres, MD
(Updated: 5/22/2024)
Click here to contact Mercedes Torres, MD
There is a growing trend toward the development of specialty-specific emergency services, such as Geriatric or Oncologic EDs.
Will this trend continue? Is the segmentation of emergency care in our future? The author of this article opines that the answer depends on future outcomes research in this area.
Brouillette M. Are Specialty Emergency Departments the Future of Emergency Care? Oncology- and Geriatric-Focused Emergency Departments Hope to Improve Care, Lower Costs. Annals of Emergency Medicine. May 2024, 83(5):9A-12A. https://doi.org/10.1016/j.annemergmed.2024.03.015
Category: Administration
Keywords: Administration, Patient Experience, Microaggression, Discrimination (PubMed Search)
Posted: 3/27/2024 by Mercedes Torres, MD
(Updated: 12/12/2024)
Click here to contact Mercedes Torres, MD
Do microaggressions and discrimination impact the patient experience in your ED? How can we address this?
This article is one of few studies to address this topic specifically in the ED. Authors used quantitative (discrimination scale) and qualitative (follow-up interviews) methods to answer this question in two urban academic EDs.
Common themes from patient responses provide food for thought and action in this regard:
Punches BE, Osuji E, Bischof JJ, et al. Patient perceptions of microaggressions and discrimination toward patients during emergency department care. Acad Emerg Med. 2023; 30: 1192-1200. doi:10.1111/acem.14767
Category: Administration
Keywords: boarding, administration, crowding (PubMed Search)
Posted: 11/22/2023 by Mercedes Torres, MD
(Updated: 12/12/2024)
Click here to contact Mercedes Torres, MD
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.
Category: Administration
Keywords: Workforce, Diversity, Under-represented minorities (PubMed Search)
Posted: 9/27/2023 by Mercedes Torres, MD
(Updated: 12/12/2024)
Click here to contact Mercedes Torres, MD
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.
Category: Administration
Keywords: age, attrition, gender, workforce (PubMed Search)
Posted: 7/26/2023 by Mercedes Torres, MD
Click here to contact Mercedes Torres, MD
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
Category: Administration
Keywords: patient experience, clinician wellbeing (PubMed Search)
Posted: 5/24/2023 by Mercedes Torres, MD
Click here to contact Mercedes Torres, MD
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.