The impact of burn-out on emergency physicians and emergency medicine residents: a systematic review

2019 ◽  
Vol 75 (1) ◽  
pp. 57-79 ◽  
Author(s):  
Delphine Verougstraete ◽  
Said Hachimi Idrissi
Keyword(s):  
Systematic Review ◽  
Emergency Medicine ◽  
Emergency Physicians ◽  
Burn Out ◽  
The Impact

scholarly journals P009: Medical assistance in dying – a survey of Canadian emergency physicians

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S66
Author(s):  
F. Bakewell
Keyword(s):  
Emergency Medicine ◽  
Terminal Illness ◽  
Free Form ◽  
Medical Attention ◽  
Emergency Physicians ◽  
Medical Assistance ◽  
Electronic Survey ◽  
Medical Assistance In Dying ◽  
Self Harm ◽  
The Impact

Introduction: There have been 3714 medically assisted deaths recorded in Canada so far, with more than half of those deaths occurring outside the hospital – whether this has had any impact on emergency medicine has not yet been documented. This survey sought to find out Canadian emergency physicians’ (EPs) attitudes and experiences with medical assistance in dying (MAID). Methods: An electronic survey was distributed to CAEP members using a modified Dillman technique. The primary outcome was defined as the proportion of EPs in favour of MAID. Secondary outcomes included experience with suicide in the setting of terminal illness, their experience and opinion on referring patients for MAID from the ED, their experience with complications of MAID, and their response to hypothetical cases of complications from MAID. Nominal variables were analyzed and reported as percentages for each relevant answer. Answers submitted as free-form text were coded into themes by the author and reported based on these themes. Results: There were 303 completed surveys. EPs were largely in support of MAID (80.5%), and would be willing to refer patients for assessment from the ED (83.2%), however fewer (58.3%) knew how to do so. 37.1% of EPs had been asked for a referral for MAID assessment, but only 12.5% had made a referral. While only 1% of EPs reported having seen patients present with complications from MAID (failed IVs in the community), 5.0% had seen patients present with suicide or self-harm attempts after being told they were ineligible for MAID by another provider. Conclusion: This is the first study to examine the impact of MAID on emergency medicine in Canada, and it demonstrates that patients are both requesting referrals through the ED and, in rare cases, requiring medical attention for complications. This has implications for both increasing awareness of MAID referral processes for EPs, as well as for the prevention and treatment of complications of MAID in the community.

scholarly journals Information Overload in Emergency Medicine Physicians: A Multisite Case Study Exploring the Causes, Impact, and Solutions in Four North England National Health Service Trusts (Preprint)

2020 ◽  
Author(s):  
Laura Sbaffi ◽  
James Walton ◽  
John Blenkinsopp ◽  
Graham Walton
Keyword(s):  
Emergency Medicine ◽  
National Health Service ◽  
Health Service ◽  
Patient Care ◽  
National Health ◽  
Medical Information ◽  
Information Overload ◽  
Group Analysis ◽  
Emergency Physicians ◽  
The Impact

BACKGROUND Information overload is affecting modern society now more than ever because of the wide and increasing distribution of digital technologies. Social media, emails, and online communications among others infuse a sense of urgency as information must be read, produced, and exchanged almost instantaneously. Emergency medicine is a medical specialty that is particularly affected by information overload with consequences on patient care that are difficult to quantify and address. Understanding the current causes of medical information overload, their impact on patient care, and strategies to handle the inflow of constant information is crucial to alleviating stress and anxiety that is already crippling the profession. OBJECTIVE This study aims to identify and evaluate the main causes and sources of medical information overload, as experienced by emergency medicine physicians in selected National Health Service (NHS) trusts in the United Kingdom. METHODS This study used a quantitative, survey-based data collection approach including close- and open-ended questions. A web-based survey was distributed to emergency physicians to assess the impact of medical information overload on their jobs. In total, 101 valid responses were collected from 4 NHS trusts in north England. Descriptive statistics, principal component analysis, independent sample two-tailed <i>t</i> tests, and one-way between-group analysis of variance with post hoc tests were performed on the data. Open-ended questions were analyzed using thematic analysis to identify key topics. RESULTS The vast majority of respondents agreed that information overload is a serious issue in emergency medicine, and it increases with time. The always available culture (mean 5.40, SD 1.56), email handling (mean 4.86, SD 1.80), and multidisciplinary communications (mean 4.51, SD 1.61) are the 3 main reasons leading to information overload. Due to this, emergency physicians experience guideline fatigue, stress and tension, longer working hours, and impaired decision making, among other issues. Aspects of information overload are also reported to have different impacts on physicians depending on demographic factors such as age, years spent in emergency medicine, and level of employment. CONCLUSIONS There is a serious concern regarding information overload in emergency medicine. Participants identified a considerable number of daily causes affecting their job, particularly the traditional culture of emergency departments being always available on the ward, exacerbated by email and other forms of communication necessary to maintain optimal, evidence-based practice standards. However, not all information is unwelcome, as physicians also need to stay updated with the latest guidelines on conditions and treatment, and communicate with larger medical teams to provide quality care.

scholarly journals Outcomes in the age of competency-based medical education: Recommendations for emergency medicine training in Canada from the 2019 symposium of academic emergency physicians

CJEM ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 204-214 ◽  
Author(s):  
Teresa M. Chan ◽  
Quinten S. Paterson ◽  
Andrew K. Hall ◽  
Fareen Zaver ◽  
Robert A. Woods ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Clinical Outcomes ◽  
Online Survey ◽  
Emergency Physicians ◽  
Competency Based Medical Education ◽  
Canadian Association ◽  
National Implementation ◽  
Competency Based ◽  
The Impact

ABSTRACTObjectivesThe national implementation of competency-based medical education (CBME) has prompted an increased interest in identifying and tracking clinical and educational outcomes for emergency medicine training programs. For the 2019 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, we developed recommendations for measuring outcomes in emergency medicine training in the context of CBME to assist educational leaders and systems designers in program evaluation.MethodsWe conducted a three-phase study to generate educational and clinical outcomes for emergency medicine (EM) education in Canada. First, we elicited expert and community perspectives on the best educational and clinical outcomes through a structured consultation process using a targeted online survey. We then qualitatively analyzed these responses to generate a list of suggested outcomes. Last, we presented these outcomes to a diverse assembly of educators, trainees, and clinicians at the CAEP Academic Symposium for feedback and endorsement through a voting process.ConclusionAcademic Symposium attendees endorsed the measurement and linkage of CBME educational and clinical outcomes. Twenty-five outcomes (15 educational, 10 clinical) were derived from the qualitative analysis of the survey results and the most important short- and long-term outcomes (both educational and clinical) were identified. These outcomes can be used to help measure the impact of CBME on the practice of Emergency Medicine in Canada to ensure that it meets both trainee and patient needs.

scholarly journals Information Overload in Emergency Medicine Physicians: A Multisite Case Study Exploring the Causes, Impact, and Solutions in Four North England National Health Service Trusts

10.2196/19126 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e19126 ◽  
Author(s):  
Laura Sbaffi ◽  
James Walton ◽  
John Blenkinsopp ◽  
Graham Walton
Keyword(s):  
Emergency Medicine ◽  
National Health Service ◽  
Health Service ◽  
Patient Care ◽  
National Health ◽  
Medical Information ◽  
Information Overload ◽  
Group Analysis ◽  
Emergency Physicians ◽  
The Impact

Background Information overload is affecting modern society now more than ever because of the wide and increasing distribution of digital technologies. Social media, emails, and online communications among others infuse a sense of urgency as information must be read, produced, and exchanged almost instantaneously. Emergency medicine is a medical specialty that is particularly affected by information overload with consequences on patient care that are difficult to quantify and address. Understanding the current causes of medical information overload, their impact on patient care, and strategies to handle the inflow of constant information is crucial to alleviating stress and anxiety that is already crippling the profession. Objective This study aims to identify and evaluate the main causes and sources of medical information overload, as experienced by emergency medicine physicians in selected National Health Service (NHS) trusts in the United Kingdom. Methods This study used a quantitative, survey-based data collection approach including close- and open-ended questions. A web-based survey was distributed to emergency physicians to assess the impact of medical information overload on their jobs. In total, 101 valid responses were collected from 4 NHS trusts in north England. Descriptive statistics, principal component analysis, independent sample two-tailed t tests, and one-way between-group analysis of variance with post hoc tests were performed on the data. Open-ended questions were analyzed using thematic analysis to identify key topics. Results The vast majority of respondents agreed that information overload is a serious issue in emergency medicine, and it increases with time. The always available culture (mean 5.40, SD 1.56), email handling (mean 4.86, SD 1.80), and multidisciplinary communications (mean 4.51, SD 1.61) are the 3 main reasons leading to information overload. Due to this, emergency physicians experience guideline fatigue, stress and tension, longer working hours, and impaired decision making, among other issues. Aspects of information overload are also reported to have different impacts on physicians depending on demographic factors such as age, years spent in emergency medicine, and level of employment. Conclusions There is a serious concern regarding information overload in emergency medicine. Participants identified a considerable number of daily causes affecting their job, particularly the traditional culture of emergency departments being always available on the ward, exacerbated by email and other forms of communication necessary to maintain optimal, evidence-based practice standards. However, not all information is unwelcome, as physicians also need to stay updated with the latest guidelines on conditions and treatment, and communicate with larger medical teams to provide quality care.

Systematic review methodology for development: An example from microfinance

2018 ◽  
Vol 43 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Carina Van Rooyen ◽  
Ruth Stewart ◽  
Thea De Wet
Keyword(s):  
Systematic Review ◽  
International Development ◽  
Health Sector ◽  
Evidence Based ◽  
Systematic Review Methodology ◽  
Development Interventions ◽  
The Us ◽  
Sub Saharan ◽  
The Impact ◽  
Evidence Based Decision Making

Big international development donors such as the UK’s Department for International Development and USAID have recently started using systematic review as a methodology to assess the effectiveness of various development interventions to help them decide what is the ‘best’ intervention to spend money on. Such an approach to evidence-based decision-making has long been practiced in the health sector in the US, UK, and elsewhere but it is relatively new in the development field. In this article we use the case of a systematic review of the impact of microfinance on the poor in sub-Saharan African to indicate how systematic review as a methodology can be used to assess the impact of specific development interventions.

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