scholarly journals Impact of Family Medicine Resident Physicians on Emergency Department Wait Times and Patients Leaving Without Being Seen

CJEM ◽  
2015 ◽  
Vol 17 (5) ◽  
pp. 475-483
Author(s):  
Wang Xi ◽  
Vikram Dalal
Keyword(s):  
Emergency Department ◽  
Family Medicine ◽  
Retrospective Chart Review ◽  
Initial Assessment ◽  
Wait Times ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Number Of Patients ◽  
Resident Group

AbstractObjectiveTo quantify the effect of family medicine resident physicians on emergency department (ED) wait times and patients leaving without being seen or treated.MethodsIn a medium-volume community ED over twelve months, we used retrospective chart review to compare wait times between patients seen during shifts where staff were working alone versus with a resident. We measured the time from initial triage time to physician initial assessment (T1) and disposition time (LOS), and number of patients leaving without being seen or treated.ResultsIn our analysis, 21,141 patients (91% of total visits) were included; 48% were in the staff-with-resident group, and 52% were in the staff-only group. Mean T1 in the resident group was significantly shorter than the staff-only group (1 hour 23 minutes versus 1 hour 38 minutes, difference 15 minutes, 95% CI 13 to 17 minutes, p<0.001). Mean total LOS in the resident group was also reduced (2 hours 38 minutes versus 2 hours 50 minutes, difference 12 minutes, 95% CI 8 to 17 minutes, p<0.001). Fewer patients left without being seen in the resident group than the staff only group (2.8% versus 4.9%, p<0.001). There were no differences in patients leaving without being treated (0.5% versus 0.5%).ConclusionsThis is the first study to demonstrate that residents are associated with a reduction in ED wait times and patients leaving without being seen in a low-acuity, community hospital, compared to previous studies demonstrating no difference or increased wait times.

scholarly journals Japanese and United States Family Medicine Resident Physicians' Attitudes about Training

2002 ◽  
Vol 3 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Michael D. Fetters ◽  
Kazuya Kitamura ◽  
Junichi Mise ◽  
Warren P. Newton ◽  
Daniel W. Gorenflo ◽  
...  
Keyword(s):  
United States ◽  
Family Medicine ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians

scholarly journals What are the knowledge, attitudes and beliefs regarding concussion of primary care physicians and family resident physicians in rural communities?

2020 ◽  
Vol 4 ◽  
pp. 205970022097454
Author(s):  
Heather Galbraith ◽  
Jairus Quesnele ◽  
Shannon Kenrick-Rochon ◽  
Sylvain Grenier ◽  
Tara Baldisera
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Assessment Tool ◽  
Local Health ◽  
Cross Sectional ◽  
Support Tool ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians

Background Primary care physicians and family medicine resident physicians report continued gaps in knowledge when diagnosing and managing pediatric patients with concussion. Methods A cross-sectional electronic survey of 130 primary care physicians and family medicine resident physicians in the Northeastern Ontario Local Health Integration Network (LHIN). Descriptive statistics, chi-squared Fisher exact tests, were used to compare physicians versus resident physicians with two-tailed p < 0.05 (with 95% confidence intervals). Results With a 48% response rate, when treating concussions 44% of providers either did not use any specific clinical practice guideline, standardized assessment tool, could not recall the source of a specific tool/guideline or omitted answering the question. However, 61% of all respondents would refer some or all concussion patients to a specialist for treatment. At least 41% of providers indicated they lacked access to a ‘Provider Decision Support Tool’ specific to concussion, and 88% of the 25 providers were without access to discharge instructions. Conclusion Similar to other jurisdictions, Northeastern Ontario primary care physicians and family medicine resident physicians report gaps in knowledge for both diagnosis and management of pediatric concussion. Consequently, they did not use current guidelines or best practices to guide management.

scholarly journals A Longitudinal Study of Burnout and Well-being in Family Medicine Resident Physicians

2020 ◽  
Vol 52 (10) ◽  
pp. 716-723
Author(s):  
Mari Ricker ◽  
Victoria Maizes ◽  
Audrey J. Brooks ◽  
Coya Lindberg ◽  
Paula Cook ◽  
...  
Keyword(s):  
Emotional Intelligence ◽  
Family Medicine ◽  
Satisfaction With Life ◽  
Core Competencies ◽  
Well Being ◽  
Targeted Interventions ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Second Year

Background and Objectives: The Accreditation Council for Graduate Medical Education (ACGME) core competencies for residency learning and work environment standards acknowledge high levels of burnout and depression in resident physicians and the critical importance of physician well-being to patient care and effective education. The objective of this study was to follow family medicine resident physicians’ well-being throughout residency. Methods: Family medicine resident physicians from 12 programs completed validated assessments (burnout, depression, perceived stress, satisfaction with life, positive and negative affect, emotional intelligence, mindfulness, gratitude) at residency start, second year start, and graduation. Resident physicians were from the 2011, 2012, and 2013 graduating classes (N=158). Results: Two indicators of burnout (emotional exhaustion, depersonalization) increased between the start of residency and the start of the second year, remaining elevated at graduation. Emotional intelligence was lower at graduation than at the start of residency. In contrast, other measures of well-being (stress, life satisfaction, affect) improved during the second and third years. Depression, mindfulness, and gratitude remained stable. Increased levels of burnout risk at graduation were negatively associated with emotional intelligence, mindfulness, and gratitude. Conclusions: While the stressful impact of residency is transitory for some measures of well-being, that is not the case for burnout or emotional intelligence. Burnout levels peak after the first year of residency and remain high through graduation. Targeted interventions to identify and address burnout in residency need to be evaluated in future studies.

scholarly journals FAMILY MEDICINE RESIDENT AWARD FOR SCHOLARSHIP

2009 ◽  
Vol 7 (1) ◽  
pp. 91-92
Author(s):  
P. J. Carek ◽  
S. Abercrombie ◽  
S. Carr ◽  
G. Dickson ◽  
J. Gravel ◽  
...  
Keyword(s):  
Family Medicine ◽  
Family Medicine Resident ◽  
Medicine Resident

scholarly journals P003: Emergency department quality assurance sepsis project: why are more people dying in southwestern Ontario?

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S78
Author(s):  
A. Aguanno ◽  
K. Van Aarsen ◽  
M. Columbus
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Retrospective Chart Review ◽  
Initial Assessment ◽  
Standardized Mortality Ratio ◽  
Local Health ◽  
Sepsis Diagnosis ◽  
Mortality Ratio ◽  
Time To Antibiotics ◽  
Statistics Canada

Introduction: London Health Sciences Centre (LHSC) includes two academic, urban hospitals in London, Canada. The hospital-standardized mortality ratio (HSMR) is consistently higher than provincial and national averages. Unpublished data reveals that sepsis contributes the largest number of statistically unexpected deaths to LHSC’s HSMR calculation. Factors contributing to in-hospital sepsis mortality are hypothesized to include demography, emergency department (ED) flow or sepsis treatment. Methods: Retrospective chart review of patients aged &gt;=18 years, presenting to an LHSC ED between 01 Nov 2014 and 31 Oct 2015, with &gt;=2 SIRS criteria and/or ED suspicion of infection and/or ED or hospital discharge sepsis diagnosis (ICD-10 diagnostic codes A4xx and R65). Data were abstracted from electronic health records. Regional, provincial and national data was retrieved from CIHI and Statistics Canada. Results: Median age and sex in London and across Canada are similar (48.2 years vs 48.9 years; 48% male vs 49% male). Baseline prevalences of diabetes, hypertension, COPD and mood disorders were similar in the Local Health Integration Network and Ontario (6% vs 7%, 19% vs 19%, 3% vs 4%, and 10% vs 8%). Median “Physician Initial Assessment,” (PIA) times for sepsis patients at LHSC were faster than median Canadian PIA times for CTAS I and II patients (CTAS I: 7 min vs 11 min, CTAS II: 34 min vs 54 min), and slower for CTAS III-V patients (CTAS III: 98 min vs 79 min, CTAS IV: 99 min vs 66 min, CTAS V: 132 min vs 53 min). Median ED length of stay for admitted, high acuity (CTAS I-III) patients was 6 h at LHSC versus 10 h across Canada.Median [IQR] time to intravenous fluid resuscitation was 60.5 min [29.8-101.2] for septic shock patients and 77.0 min [36.0-127.0] for expired patients. Median [IQR] time to antibiotics was 130 min [73.0-229.0] for sepsis patients, 106 min [60.0-189.0] for severe sepsis patients, and 82 min [42.2-142] for septic shock patients. Conclusion: Excess sepsis-related mortality at LHSC is not convincingly related to patient demographics or ED flow. Gains may be made by improving time to antibiotics and IV fluids.

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