Familiarity, Load, and Patient Pick-Up: The Positive and Negative Effects of Group Composition on Physician Behavior in the Emergency Department

2020 ◽  
Author(s):  
Robert J. Niewoehner ◽  
Diwas Singh KC ◽  
Bradley R. Staats
Keyword(s):  
Emergency Department ◽  
Group Composition ◽  
Physician Behavior ◽  
Negative Effects

scholarly journals The negative effects of COVID-19 and national lockdown on emergency surgery morbidity due to delayed access

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Francesco A. Ciarleglio ◽  
Marta Rigoni ◽  
Liliana Mereu ◽  
Cai Tommaso ◽  
Alessandro Carrara ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Transfusion ◽  
Emergency Surgery ◽  
Surgical Care ◽  
Close Correlation ◽  
Negative Effects ◽  
Group 2 ◽  
Retrospective Comparative Study ◽  
The Impact ◽  
Group 1

Abstract Background The aim of this retrospective comparative study was to assess the impact of COVID-19 and delayed emergency department access on emergency surgery outcomes, by comparing the main clinical outcomes in the period March–May 2019 (group 1) with the same period during the national COVID-19 lockdown in Italy (March–May 2020, group 2). Methods A comparison (groups 1 versus 2) and subgroup analysis were performed between patients’ demographic, medical history, surgical, clinical and management characteristics. Results Two-hundred forty-six patients were included, 137 in group 1 and 109 in group 2 (p = 0.03). No significant differences were observed in the peri-operative characteristics of the two groups. A declared delay in access to hospital and preoperative SARS-CoV-2 infection rates were 15.5% and 5.8%, respectively in group 2. The overall morbidity (OR = 2.22, 95% CI 1.08–4.55, p = 0.03) and 30-day mortality (OR = 1.34, 95% CI 0.33–5.50, =0.68) were significantly higher in group 2. The delayed access cohort showed a close correlation with increased morbidity (OR = 3.19, 95% CI 0.89–11.44, p = 0.07), blood transfusion (OR = 5.13, 95% CI 1.05–25.15, p = 0.04) and 30-day mortality risk (OR = 8.00, 95% CI 1.01–63.23, p = 0.05). SARS-CoV-2-positive patients had higher risk of blood transfusion (20% vs 7.8%, p = 0.37) and ICU admissions (20% vs 2.6%, p = 0.17) and a longer median LOS (9 days vs 4 days, p = 0.11). Conclusions This article provides enhanced understanding of the effects of the COVID-19 pandemic on patient access to emergency surgical care. Our findings suggest that COVID-19 changed the quality of surgical care with poorer prognosis and higher morbidity rates. Delayed emergency department access and a “filter effect” induced by a fear of COVID-19 infection in the population resulted in only the most severe cases reaching the emergency department in time.

scholarly journals Profile Of Burn Victims Attended By An Emergency Unit

10.3823/2280 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Lidiane Souza Lima ◽  
Viviane Oliveira de Sousa Correia ◽  
Tycianne Karoline Garção Nascimento ◽  
Bárbara Jeane Pinto Chaves ◽  
José Rodrigo Santos Silva ◽  
...  
Keyword(s):  
Emergency Department ◽  
Preventive Measures ◽  
Lower Limbs ◽  
Health Profile ◽  
Emergency Unit ◽  
Negative Effects ◽  
Burn Treatment ◽  
Treatment Unit ◽  
Burn Victims ◽  
Current Scenario

Objectives: to identify the sociodemographic and health profile of burn victims, knowing the characteristics of the events and detecting the major analgesics prescribed in the emergency department. Methods: descriptive, exploratory and quantitative study with 16 burn victims treated at a Burn Treatment Unit from October 2015 to May 2016. Results: the average age of participants was 31.8 years (± 14.1). Mostly, the subjects were male (62.5%), single (43.8%), brown (68.8%), economically active (75.0%) and coming from Aracaju and its surroundings (62.5%). Injuries from burns were mostly of second degree (93.8%) and reached the lower limbs (68.8%). The average burned body surface was 15.8% (± 11.5). The circumstances surrounding burns occurred mainly at home (50.0%), on Sundays (25.0%) and in the shifts morning (37.5%) and night (37.5%). The main etiological agent was alcohol (31.3%). All patients received analgesia in the emergency department, but the minority had pain documented (18.8%). The physician was the only professional who reported pain in their records, but did incompletely (18.8%). Conclusion: due to the negative effects of burns, it is crucial to adopt educational and preventive measures to change the current scenario of epidemiology of such trauma. Keywords: Burns; Epidemiology; Analgesia; Emergency.

scholarly journals Effect of Real-Time Surveys on Patient Satisfaction Scores in the Emergency Department

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Julia Sobel ◽  
Jessica Bates ◽  
Vivienne Ng ◽  
Matthew Berkman ◽  
Tomas Nuño ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Real Time ◽  
Physician Behavior ◽  
Resident Physicians ◽  
Patient Satisfaction Scores ◽  
Behavior Modifications ◽  
Satisfaction Measures ◽  
Attending Physicians ◽  
Satisfaction Surveys

Background. Patient satisfaction surveys have become increasingly important as their results help to determine Centers for Medicare and Medicaid Services (CMS) reimbursement. However, these questionnaires have known sources of bias (self-selection, responder, attribution, and nonresponse). Objective. We developed a real-time (RT) survey delivered in the hospital ED to evaluate the effect of implementing RT patient satisfaction surveys on physician behavior and hypothesized that the timing of patient satisfaction survey delivery would significantly impact the results. Method. Data from real-time patient satisfaction surveys were collected in phases from 12/2015 to 5/2017. Hospital-sponsored (HS) surveys were administered after discharge from 12/2015 to 12/2016. Results. For RT surveys, resident physicians were significantly more likely to write their names on the whiteboard (p=0.02) and sit down (p=0.01) with patients. Behavior modifications by attending physicians were not significant. Patient satisfaction measures did not improve significantly between periods for RT or HS surveys; however, RT survey responders were significantly more likely to recommend the ED to others. Conclusion. The timing of survey administration did significantly alter resident physician’s behavior; however, it had no effect on patient satisfaction scores. RT responders were significantly more likely to recommend the emergency department to others.

scholarly journals Emotional Exhaustion and Professional Satisfaction during Covid-19 Pandemic at the Level of Emergency Department Staff

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Cosmina-Alina Moscu ◽  
Mihaela Anghele ◽  
Liliana Dragomir ◽  
Sorina Munteanu ◽  
Aurelian Anghele ◽  
...  
Keyword(s):  
Emergency Department ◽  
Stress Level ◽  
Working Hours ◽  
Average Score ◽  
Work Place ◽  
Professional Satisfaction ◽  
Negative Effects ◽  
Civil Status ◽  
Socio Demographic Factors ◽  
High Level

Introduction: Burnout is a syndrome conceptualized as result of the chronic stress at the work place which was not successfully managed. The possible negative effects on the medical staff, the patients and the health institutions have generated interest and motivated the research to understand the possible causes, these effects also influence the burnout predictors. The medical services suppliers within the emergency department have had one of the greatest exhaution occurences even before the pandemic. Being in the first line in contact with the suspected patients or confirmed with COVID-19 infection intensifies this fact. Both the working factors (working hours, years of practice, number of treated patients, professional development activities) and the socio- demographic factors (age, sex, civil status, income, education) are associated with the exhaustion at the work place. Material and methods: I have studied a total of 120 participants, receiving 115 valid questionnaires, the answering ratio being 95,83%. This was a descriptive, multicentre, transversal study of the medical and the auxiliary staff within the department UPU-SMURD of the County Clinic Emergency Hospital “Sf. Ap. Andrei” Galați. The staff gave their consent and attended a combined interview which consisted of a pilot questionnaire and a demographic questionnaire. Results and discussions: The average score of exhaustion at the staff level was 3.25, a great percentage of the doctors within the ED (45.8%), (n=24) indicates an increased level of exhaustion, only 26.8% (n=80) of nurses show an increased level of exhaustion. The average score of the stress level shown by the staff is 3.1, 66.6% (n=24) among which the doctors with an increased stress level 9.1% (n=9) auxiliary staff, 23.8% (n=80) of nurses. Conclusions: The results show us a high exhaustion, stress and depression ratio at the emergency doctors in comparison with the other professional categories within the ED. A high level of professional satisfaction is accompanied by an increased level of stress and of self-esteem.

scholarly journals Physical domestic violence trauma among women referred to the emergency department of imam khomeini hospital, urmia, iran

2021 ◽  
pp. 72-78
Keyword(s):  
Emergency Department ◽  
Domestic Violence ◽  
Elementary Education ◽  
Physical Violence ◽  
Cross Sectional Study ◽  
Education Level ◽  
Negative Effects ◽  
Chi Square ◽  
Cross Sectional ◽  
Trauma Severity

Introduction: Domestic violence is the most common form of violence against women that has negative effects on the health of the mother, children, family, and society. This study aimed to evaluate the trauma caused by physical violence in women referred to the Emergency Department of Imam Khomeini Hospital, Urmia, Iran. Method: This descriptive cross-sectional study was performed on women referred to the Emergency Department of Imam Khomeini Hospital, Urmia, Iran, with trauma in the First quarter of 2016. The patient files were used to collect the required data. Subsequently, the obtained data were analyzed in SPSS software (version 18) through the chi-square test (P<0.001) Results: In total, 1746 women with trauma were referred to the Emergency Department in the First quarter of 2016, 38 of whom reported physical domestic violence. The mean age of the women was 37.57±5.54 years; moreover, 16 (42.1%) cases had elementary education, and 20 (52.6%) women were urban dwellers. Regarding the marital status, 33(86.8%)women were married. Considering the relationship between trauma severity and demographic characteristics, only education level showed a correlation with trauma severity. In total 14 (36.8%) and 11 (29%) cases had mild and severe traumas, respectively. Furthermore, the most injured parts were the limbs (n=16; 42.1%). Conclusion: The results showed a significant increase in the severity of trauma in women with lower education levels. Accordingly, improvements in the level of education may decrease the prevalence and severity of physical domestic violence, which requires appropriate planning to increase women's education level.

scholarly journals Study of submerged cases of violence on healthcare workers in an emergency department

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Piras ◽  
G Piras ◽  
I Portoghese ◽  
A Azara ◽  
A Piana ◽  
...  
Keyword(s):  
Emergency Department ◽  
Risk Management ◽  
Healthcare Workers ◽  
Reporting System ◽  
Southern Italy ◽  
Prevention Measures ◽  
Negative Effects ◽  
Security Guards ◽  
Protection Strategies ◽  
Management Reporting

Abstract Background Violence at work has negative effects on both workers and organizations. Among healthcare workers, nurses are the professionals most at risk, especially those who work in emergency departments. However, literature data are estimated to be the tip of the iceberg. The study aims at analyze violence events that are not reported by professionals via common reporting system, in order to measure the real extent of the problem and allow the organizations introducing adequate prevention measures. Methods The study took place in November 2016 in an emergency department in Southern Italy. A retrospective analysis was carried out by reviewing both the delivery registers (DR) used by nurses and doctors during the service, and the reports of security guards (RSG), in the period between 2011 and 2015. Results The results show that violence frequency was higher than that present in the risk management reporting (only one case). In the DR, 40 violence events were reported, yet in the RSG, 109 cases were registered. More nurses (n = 33) than doctors (n = 8) reported violence events in the DR. In the RSG, guards reported the same number of cases involving nurses, and 26 cases for doctors. In 50 cases, the professional involved was not specified. The violence type was physical (5 DR vs 13 RSG), physical threats or attempted violence (4 DR vs 13 RSG), and verbal (24 DR vs 67 RSG). Weapons (e.g., knife, hammer, syringe) were used in 2 cases as reported in DR and in 4 cases according to RSG. The aggressor was mainly the patient (15 DR vs 83 RSG) and the companion (14 DR vs 16 RSG). The shifts with more frequency of events are afternoon (15 DR vs 40 RSG) and night (12 DR vs 48 RSG). Conclusions The data show an amount of submerged cases and highlight a discrepancy between report of professionals and violence events where security guards intervened. Key messages Under-reporting violence cases require attention by the organizations. Prevention and protection strategies must be implemented. The use of the reporting system must be improved.

Information for caregivers and family in the Emergency Department

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Raquel Rocha ◽  
Flávia Silva ◽  
Ana Bastos ◽  
Samuel Lopes
Keyword(s):  
Emergency Department ◽  
Health Professionals ◽  
Information Needs ◽  
Negative Impact ◽  
Phenomenological Approach ◽  
Scientific Language ◽  
Structured Interviews ◽  
Negative Effects ◽  
Public Road ◽  
Lack Of Information

ABSTRACT Introduction: A visit to the Emergency Department can have a negative impact on patients, their families and caregivers. To overcome negative effects linked to the lack of information, it is necessary to involve the patient’s family and caregivers and evaluate their information needs. Aims: Identify the information that caregivers need from the families in an emergency department; understand how often information should be given to the caregivers; identify the health professionals most qualified to impart the information and identify all the communication barriers experience by caregivers. Methods: This research is a qualitative study with descriptive phenomenological approach. We carried out 38 semi - structured interviews on a public road close to an Emergency Department, from February to March 2018. Data were analysed according to the descriptive phenomenological method of Amedeo Giorgi (1985,1997). Results: Caregivers identified receiving information about the patient as a priority. They also wanted to receive information about the patient more often from doctors and/or nurses. In addition, caregivers identified the use of medical/scientific language by health professionals as possible barriers to communication between them. Other concerns raised included the attitude of the health professional, their availability and the lack of communication. Conclusions: Caregivers should be seen as an important and essential pillar of the healthcare system. The information provided by health professionals should be adjusted to the needs of the caregivers. Keywords: Access to Information, Emergency Medical Services.

Awareness of Lab Test Price Tags Sways Physician Behavior

2011 ◽  
Vol 4 (6) ◽  
pp. 1-6
Author(s):  
MARY ELLEN SCHNEIDER
Keyword(s):  
Physician Behavior ◽  
Lab Test
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