scholarly journals Choosing Wisely Canada's emergency medicine recommendations: Time for a revision

CJEM ◽  
2019 ◽  
Vol 21 (6) ◽  
pp. 717-720 ◽  
Author(s):  
Amy H. Y. Cheng ◽  
Sam Campbell ◽  
Lucas B. Chartier ◽  
Shawn Dowling ◽  
Tom Goddard ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Working Group ◽  
Ad Hoc ◽  
Choosing Wisely ◽  
Emergency Physicians ◽  
Medical Tests ◽  
Canadian Association ◽  
National Initiative ◽  
New Evidence

ABSTRACTChoosing Wisely Canada (CWC) is a national initiative designed to encourage patient-clinician discussions about the appropriate, evidence-based use of medical tests, procedures and treatments. The Canadian Association of Emergency Physicians’ (CAEP) Choosing Wisely Canada (CWC) working group developed and released ten recommendations relevant to Emergency Medicine in June 2015 (items 1–5) and October 2016 (items 6–10). In November 2016, the CAEP CWC working group developed a process for updating the recommendations. This process involves: 1) Using GRADE to evaluate the quality of evidence, 2) reviewing relevant recommendations on an ad hoc basis as new evidence emerges, and 3) reviewing all recommendations every five years. While the full review of the CWC recommendations will be performed in 2020, a number of high-impact studies were published after our initial launch that prompted an ad hoc review of the relevant three of our ten recommendations prior to the full review in 2020. This paper describes the results of the CAEP CWC working group's ad hoc review of three of our ten recommendations in light of recent publications.

scholarly journals The core emergency ultrasound curriculum project: A report from the Curriculum Working Group of the CAEP Emergency Ultrasound Committee

CJEM ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Paul Olszynski ◽  
Dan Kim ◽  
Jordan Chenkin ◽  
Louise Rang
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Working Group ◽  
Focused Ultrasound ◽  
Position Statement ◽  
Emergency Ultrasound ◽  
Emergency Physicians ◽  
The Core ◽  
Canadian Association ◽  
Curriculum Project

Emergency ultrasound (EUS) is now widely considered to be a “skill integral to the practice of emergency medicine.”1The Canadian Association of Emergency Physicians (CAEP) initially issued a position statement in 1999 supporting the availability of focused ultrasound 24 hours per day in the emergency department (ED).2

scholarly journals Choosing Wisely Canada®: Five tests, procedures and treatments to question in Emergency Medicine

CJEM ◽  
2017 ◽  
Vol 19 (S2) ◽  
pp. S9-S17 ◽  
Author(s):  
Amy H. Y. Cheng ◽  
Sam Campbell ◽  
Lucas B. Chartier ◽  
Tom Goddard ◽  
Kirk Magee ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Head Injuries ◽  
Clinical Decision ◽  
Choosing Wisely ◽  
Emergency Physicians ◽  
Spinal Imaging ◽  
Canadian Association ◽  
Frequency Of Use ◽  
Expert Working Group ◽  
Adults And Children

AbstractObjectivesChoosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians’ (CAEP) top five list of recommendations, and the process undertaken to generate them.MethodsThe CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned. This list was distributed to CAEP committee chairs, revised, and then divided and randomly allocated to 107 Canadian emergency physicians (EWG nominated) who voted on each item based on: action-ability, effectiveness, safety, economic burden, and frequency of use. The EWG discussed the items with the highest votes, and generated the recommendations by consensus.ResultsThe top five CAEP CWC recommendations are: 1) Don’t order CT head scans in adults and children who have suffered minor head injuries (unless positive for a validated head injury clinical decision rule); 2) Don’t prescribe antibiotics in adults with bronchitis/asthma and children with bronchiolitis; 3) Don’t order lumbosacral spinal imaging in patients with non-traumatic low back pain who have no red flags/pathologic indicators; 4) Don’t order neck radiographs in patients who have a negative examination using the Canadian C-spine rules; and 5) Don’t prescribe antibiotics after incision and drainage of uncomplicated skin abscesses unless extensive cellulitis exists.ConclusionsThe CWC recommendations for emergency medicine were selected using a mixed methods approach. This top 5 list was released at the CAEP Conference in June 2015 and should form the basis for future implementation efforts.

scholarly journals How to improve quality of care in overcrowded emergency departments? Development and evaluation of a virtual research environment. (Preprint)

2019 ◽  
Author(s):  
Charles-Henri Houze Cerfon ◽  
Christine Vaissié ◽  
Laurent Gout ◽  
Bruno Bastiani ◽  
Sandrine Charpentier ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Quality Of Care ◽  
Simulated Patients ◽  
Emergency Physicians ◽  
Research Environment ◽  
Significant Difference ◽  
Ed Overcrowding ◽  
Virtual Research Environment

BACKGROUND Despite wide literature on ED overcrowding, scientific knowledge on emergency physicians’ cognitive processes coping with overcrowding is limited. OBJECTIVE We sought to develop and evaluate a virtual research environment that will allow us to study the effect of physicians’ strategies and behaviours on quality of care in the context of emergency department overcrowding. METHODS A simulation-based observational study was conducted over two stages: the development of a simulation model and its evaluation. A research environment in Emergency Medicine combining virtual reality and simulated patients has been designed and developed. Then, twelve emergency physicians took part in simulation scenarios and had to manage thirteen patients during a 2-hour period. The study outcome was the authenticity of the environment through realism, consistency and mastering. The realism was the resemblance perceived by the participants between virtual and real Emergency Department. The consistency of the scenario and the participants’ mastering of the environment was expected for 90% of the participants. RESULTS The virtual emergency department was considered realistic with no significant difference from the real world concerning facilities and resources except for the length of time of procedures that was perceived to be shorter. 100% of participants deemed that patient information, decision-making and managing patient flow were similar to real clinical practice. The virtual environment was well-mastered by all participants over the course of the scenarios. CONCLUSIONS The new simulation tool, Virtual Research Environment in Emergency Medicine has been successfully designed and developed. It has been assessed as perfectly authentic by emergency physicians compared to real EDs and thus offers another way to study human factors, quality of care and patient safety in the context of ED overcrowding.

scholarly journals Building and strengthening relationships between academic departments/divisions of emergency medicine and rural and regional emergency departments

CJEM ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 595-599 ◽  
Author(s):  
Aaron Johnston ◽  
Kylie Booth ◽  
Jim Christenson ◽  
David Fu ◽  
Shirley Lee ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Emergency Departments ◽  
Academic Departments ◽  
List Type ◽  
Emergency Physicians ◽  
Common Value ◽  
Rural And Urban ◽  
Canadian Association ◽  
Rural Physicians ◽  
Training Opportunities

ABSTRACTObjectivesMake recommendations on approaches to building and strengthening relationships between academic departments or divisions of Emergency Medicine and rural and regional emergency departments.MethodsA panel of leaders from both rural and urban/academic practice environments met over 8 months. Draft recommendations were developed from panel expertise as well as survey data and presented at the 2018 Canadian Association of Emergency Physicians (CAEP) Academic Symposium. Symposium feedback was incorporated into final recommendations.ResultsSeven recommendations emerged and are summarized below: 1)CAEP should ensure engagement with other rural stakeholder organizations such as the College of Family Physicians of Canada and the Society of Rural Physicians of Canada.2)Engagement efforts require adequate financial and manpower resources.3)Training opportunities should be promoted.4)The current operational interface between the academic department of Emergency Medicine and the emergency departments in the catchment area must be examined and gaps addressed as part of building and strengthening relationships.5)Initial engagement efforts should be around projects with common value.6)Academic Departments should partner with and support rural scholars.7)Academic departments seeking to build or strengthen relationships should consider successful examples from elsewhere in the country as well as considering local culture and challenges.ConclusionThese recommendations serve as guidance for building and strengthening mutually beneficial relationships between academic departments or divisions of Emergency Medicine and rural and regional emergency departments.

scholarly journals Important returns on investment: an evaluation of a national research grants competition in emergency medicine

CJEM ◽  
2010 ◽  
Vol 12 (01) ◽  
pp. 33-38 ◽  
Author(s):  
Jaime Bawden ◽  
Namdar Manouchehri ◽  
Cristina Villa-Roel ◽  
Eric Grafstein ◽  
Brian H. Rowe
Keyword(s):  
Emergency Medicine ◽  
Research Funding ◽  
Emergency Physicians ◽  
Research Grants ◽  
Annual Basis ◽  
Canadian Association ◽  
Additional Funding ◽  
Study Completion ◽  
Returns On Investment ◽  
Median Amount

ABSTRACTObjective:We sought to examine scholarly outcomes of the projects receiving research grants from the Canadian Association of Emergency Physicians (CAEP) during the first 10 years of national funding (i.e., between 1996 and 2005).Methods:We sent email surveys to 62 emergency medicine (EM) researchers who received funding from CAEP. We focused our data collection on grant deliverables and opinions using a 1–7 Likert scale with regard to the value of the award.Results:Fifty-eight recipients responded to our survey. Grants were most commonly awarded to residents (21 [36%]), followed by senior (16 [28%]) and junior (13 [22%]) emergency staff. Twenty-six applicants from Ontario and 11 from Quebec received the majority of the grants. Overall, 51 projects were completed at the time of contact and, from these, 39 manuscripts were published or in press. Abstract presentations were more common, with a median of 2 abstracts presented per completed project. Abstract presentations for the completed projects were documented locally (23), nationally (39) and internationally (37). Overall, 19 projects received additional funding. The median amount funded was Can$4700 with an interquartile range of $3250–$5000. Respondents felt CAEP funding was critical to completing their projects and felt strongly that dedicated EM research funding should be continued to stimulate productivity.Conclusion:Overall, the CAEP Research Grants Competition has produced impressive results. Despite the small sums available, the grants have been important for ensuring study completion and for securing additional funding. CAEP and similar EM organizations need to develop a more robust funding approach so that larger grant awards and more researchers can be supported on an annual basis.

scholarly journals Development and Evaluation of a Virtual Research Environment to Improve Quality of Care in Overcrowded Emergency Departments: Observational Study

10.2196/13993 ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. e13993
Author(s):  
Charles-Henri Houze-Cerfon ◽  
Christine Vaissié ◽  
Laurent Gout ◽  
Bruno Bastiani ◽  
Sandrine Charpentier ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Quality Of Care ◽  
Observational Study ◽  
Emergency Physicians ◽  
Research Environment ◽  
Wide Range ◽  
Significant Difference ◽  
Ed Overcrowding ◽  
Virtual Research Environment

Background Despite a wide range of literature on emergency department (ED) overcrowding, scientific knowledge on emergency physicians’ cognitive processes coping with overcrowding is limited. Objective This study aimed to develop and evaluate a virtual research environment that will allow us to study the effect of physicians’ strategies and behaviors on quality of care in the context of ED overcrowding. Methods A simulation-based observational study was conducted over two stages: the development of a simulation model and its evaluation. A research environment in emergency medicine combining virtual reality and simulated patients was designed and developed. Afterwards, 12 emergency physicians took part in simulation scenarios and had to manage 13 patients during a 2-hour period. The study outcome was the authenticity of the environment through realism, consistency, and mastering. The realism was the resemblance perceived by the participants between virtual and real ED. The consistency of the scenario and the participants’ mastering of the environment was expected for 90% (12/13) of the participants. Results The virtual ED was considered realistic with no significant difference from the real world with respect to facilities and resources, except for the length of time of procedures that was perceived to be shorter. A total of 100% (13/13) of participants deemed that patient information, decision making, and managing patient flow were similar to real clinical practice. The virtual environment was well-mastered by all participants over the course of the scenarios. Conclusions The new simulation tool, Virtual Research Environment in Emergency Medicine, has been successfully designed and developed. It has been assessed as perfectly authentic by emergency physicians compared with real EDs and thus offers another way to study human factors, quality of care, and patient safety in the context of ED overcrowding.

scholarly journals “The Future of Emergency Medicine” Inaugural address to the First Canadian EM Residents Workshop

CJEM ◽  
2000 ◽  
Vol 2 (04) ◽  
pp. 262-264 ◽  
Author(s):  
Isser Dubinsky
Keyword(s):  
Emergency Medicine ◽  
Emergency Services ◽  
Emergency Physicians ◽  
Inaugural Address ◽  
Health Network ◽  
Canadian Association ◽  
The Future ◽  
National Forum ◽  
The University

On June 10 to 11 this year, the Residents’ Section of the Canadian Association of Emergency Physicians (CAEP-RS) held its first official national forum for future emergency physicians — the First Canadian EM Residents Workshop, in conjunction with CAEP 2000. To celebrate the event, the RS decided to invite a nationally recognized emergency medicine leader, advocate, and teacher to be the first to address the Annual Residents’ Dinner. We were grateful for the privilege of having Dr. Isser Dubinsky be that person. Dr. Dubinsky, currently Chief of Emergency Services at the University Health Network in Toronto, was asked to speak about “The Future of Emergency Medicine.” Dr. Dubinsky's speech, filled with warmth, wisdom, and humanity, is transcribed below. — Jason Frank, MD, Chair CAEP-RS

Developing the role of emergency physicians in humanitarian assistance and disaster response

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A7.3-A8
Author(s):  
Najeeb Rahman
Keyword(s):  
Emergency Medicine ◽  
Disaster Response ◽  
Ad Hoc ◽  
Skills Training ◽  
Humanitarian Assistance ◽  
Emergency Physicians ◽  
Medical Response ◽  
Health Response ◽  
Response Team

ObjectiveTo review and summarise information from Reliefweb (information website hosted by the Office for the Coordination of Humanitarian Affairs) regarding medical response during the first 2 weeks following Pakistan Earthquake of 2005, and the Haiti Earthquake of 2010. This information, used in conjunction with personal experiences, will demonstrate the value that emergency physicians can contribute as part of a disaster response team during humanitarian aid efforts.MethodsAll situation reports authored by the WHO (who have lead responsibility in coordinating the health response during a disaster) which were published on Reliefweb during the first 2 weeks following the relevant earthquakes were selected. These reports were screened for information relating to numbers of deaths, injuries and illness, as well as number of non-governmental organisations (NGOs)/aid groups participating in efforts, in addition to operational health facilities and capacities.ResultsSummary of the reports demonstrate the rapid increase in patient numbers and NGO participation, as well as the challenges of coordination, communication, resourcing and planning, in addition to appropriate patient management. These findings help to outline the skills required to participate and respond to such crises, many of which constitute part of emergency medicine practice.ConclusionVolunteer participation by doctors during the first few weeks following such disasters continues. However, such participation occurs in an ad-hoc fashion, with many working through a variety of NGOs, but without appropriate coordination and relevant basic training.The College of Emergency Medicine is well placed to support such efforts. This could initially be done by establishing a working group under the auspices of the College, whose role would be support the skills training of doctors wishing to volunteer, as well as work with other associations, colleges, NGOs and Government, so as to better respond to such disasters in the future, with a consolidated role for emergency physicians.

scholarly journals CAEP 2015 Academic Symposium: Recommendations for University Governance and Administration for Emergency Medicine

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S18-S25 ◽  
Author(s):  
David Petrie ◽  
Anil Chopra ◽  
Alecs Chochinov ◽  
Jennifer D. Artz ◽  
Michael Schull ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Good Governance ◽  
Local Environment ◽  
Essential Elements ◽  
Current Status ◽  
Emergency Physicians ◽  
Canadian Association ◽  
Academic Units ◽  
Research And Education ◽  
Exceptional Patient

AbstractObjective1) To identify the strengths and challenges of governance structures in academic emergency medicine (EM), and 2) to make recommendations on principles and approaches that may guide improvements.MethodsOver the course of 9 months, eight established EM leaders met by teleconference, reviewed the literature, and discussed their findings and experiences to arrive at recommendations on governance in academic units of EM. The results and recommendations were presented at the annual Canadian Association of Emergency Physicians (CAEP) Academic Symposium, where attendees provided feedback. The updated recommendations were subsequently distributed to the CAEP Academic Section for further input, and the final recommendations were decided by consensus.ResultsThe panel identified four governance areas of interest: 1) the elements of governance; 2) the relationships between emergency physicians and academic units of EM, and between the academic units of EM and faculty of medicine; 3) current status of governance in Canadian academic units of EM; and 4) essential elements of good governance. Six recommendations were developed around three themes, including 1) the importance of good governance; 2) the purposes of an academic unit of EM; and 3) essential elements for better governance for academic units of EM. Recommendations included identifying the importance of good governance, recognizing the need to adapt to the different models depending on the local environment; seeking full departmental status, provided it is mutually beneficial to EM and the faculty of medicine (and health authority); using a consultation service to learn from the experience of other academic units of EM; and establishing an annual forum for EM leaders.ConclusionAlthough governance of academic EM is complex, there are ways to iteratively improve the mission of academic units of EM: providing exceptional patient care through research and education. Although there is no one-size-fits-all guide, there are practical recommended steps for academic units of EM to consider.

scholarly journals Building a national organization of future emergency medicine physicians

CJEM ◽  
1999 ◽  
Vol 1 (02) ◽  
pp. 132
Author(s):  
Jason R. Frank
Keyword(s):  
Emergency Medicine ◽  
Family Medicine ◽  
Royal College ◽  
Training Programs ◽  
Emergency Physicians ◽  
National Organization ◽  
New Family ◽  
Canadian Association ◽  
Family Medicine Residents

Resident interest in emergency medicine (EM) is on the rise. Each year, postgraduate matches add to the ranks of Canadian EM residents, and the Canadian Association of Emergency Physicians (CAEP) Residents’ Section (RS) continues to expand. The numbers are inspiring. This year, 16 residents accepted Royal College EM postgraduate year-1 (PGY-1) slots. Many more began their CCFP(EM) PGY-3 year, and this doesn’t include the residents who matched separately to EM training programs in Quebec. At the same time, the Canadian Resident Matching Service (CaRMS) matched about 433 new Family Medicine residents and 63 new Pediatrics residents. A significant number of these groups will also go on to develop interests and skills in EM.

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