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)

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.

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

Journal of Medical Internet Research ◽

10.2196/19126 ◽

2020 ◽

Vol 22 (7) ◽

pp. e19126 ◽

Cited By ~ 1

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.

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THE UK NHS EXPERIENCE OF BURNOUT: TIME FOR ACTION

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v9i3.994 ◽

2021 ◽

Vol 9 (3) ◽

pp. 7-18

Author(s):

Helen L. Millar

Keyword(s):

Health Care ◽

National Health Service ◽

Health Service ◽

Patient Care ◽

National Health ◽

Health Care Professionals ◽

Care Delivery ◽

Work Place ◽

The Uk ◽

The Impact

Background: Burnout, as a global phenomenon, has probably always existed and been present in all cultures but more recently has been increasingly identified in the public health sector work place. The UK National Health Service (NHS) is the largest employer in Europe with over 1.3 million workers. It therefore reflects many of the challenges common to global health care systems. The escalation of burnout in the UK NHS (National Health Service) is now recognized given the impact on workforce sustainability and the health care delivery. Objectives: This article aims to highlight the current epidemic of burnout in the UK NHS, its causes, and impact on the workforce and quality of care provided. Strategies developed to improve the health of the NHS workforce will be reviewed and appraised in terms of their impact and limitations to date. Methods: The methodology includes a broad overview of selected articles/publications focusing on the concept of burnout and the impact on the workforce and patient care and is not intended to be a systematic review. Publications include peer reviewed articles, governmental strategic documents, recent surveys, and relevant responses by health care professionals and other relevant independent bodies. Results: The current literature highlights that burnout in the NHS is a major concern. It is clear that recognition of the extent of the problem and its impact are crucial for the sustainability of the NHS. The alarming rate of work force attrition is evident and unless immediate drastic steps are taken to address the root causes, the pressure on remaining staff will escalate to breaking point resulting in an inability to sustain services due to further staff losses. Evidence demonstrates that staff burnout adversely affects patient care and increases errors. Conclusion: It is vital that burnout is addressed as a matter of urgency in order to ensure a healthy and productive workforce and to ensure patients are treated safely and effectively. The NHS’s very survival depends on direct and urgent action to remedy this situation.

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The Impact of Austerity on the Portuguese National Health Service, Citizens’ Well-Being, and Health Inequalities

e-cadernos CES ◽

10.4000/eces.4187 ◽

2019 ◽

Cited By ~ 1

Author(s):

Pedro Hespanha

Keyword(s):

National Health Service ◽

Health Service ◽

Health Inequalities ◽

National Health ◽

Well Being ◽

The Impact

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The lost worlds of royal commissions in the NHS: The unaccountable in pursuit of the unanswerable?

Teaching Public Administration ◽

10.1177/0144739419830449 ◽

2019 ◽

Vol 37 (2) ◽

pp. 199-217

Author(s):

Martin Powell

Keyword(s):

National Health Service ◽

Health Service ◽

National Health ◽

Royal Commission ◽

Select Committee ◽

House Of Lords ◽

The Impact ◽

British National Health ◽

Advisory Bodies

There have been recent calls for a royal commission (RC) on the British National Health Service (NHS). This article focuses on the impact of RCs and similar advisory bodies, particularly on finance recommendations, of three inquiries with broad remits across the whole of the NHS from very different periods: Guillebaud (1956); Royal Commission on the National Health Service (1979); and House of Lords Select Committee on the Long-term Sustainability of the NHS (2017). These inquiries appear to have had rather limited impacts, especially on NHS funding. First, there appears to be some hesitancy in suggesting precise figures for NHS expenditure. Second, the reports are advisory, and governments can ignore their conclusions. Third, governments have ignored their conclusions. In the 1950s and the 1980s, contrary to the recommendations of the inquiries, NHS expenditure subsequently grew only slowly, and charges were increased. In short, asking an independent RC to provide answers on NHS expenditure is perhaps the unaccountable in pursuit of the unanswerable.

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Psychiatric In-Patients and Out-Patients: A Reply to Mezey and Evans

The British Journal of Psychiatry ◽

10.1192/bjp.120.557.433 ◽

1972 ◽

Vol 120 (557) ◽

pp. 433-436 ◽

Cited By ~ 1

Author(s):

D. G. Morgan ◽

R. M. Compton

Keyword(s):

Mental Health ◽

National Health Service ◽

Health Service ◽

Social Security ◽

Patient Care ◽

National Health ◽

Effects of the National Institute for Health and Clinical Excellence's technology appraisals on prescribing and net ingredient costs of drugs in the National Health Service in England

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462309990110 ◽

2009 ◽

Vol 25 (03) ◽

pp. 262-271 ◽

Cited By ~ 8

Author(s):

Eva Susanne Dietrich

Keyword(s):

National Health Service ◽

Health Service ◽

Ambulatory Care ◽

National Health ◽

Role Model ◽

Regression Analyses ◽

England And Wales ◽

Department Of Health ◽

Prescription Costs ◽

The Impact

Objectives:The aim of this study was to examine the impact of the National Institute for Health and Clinical Excellence's (NICE's) negative and restricting technology appraisals on the number of prescription items dispensed and the corresponding total net ingredient costs for drugs from 2000 to 2004 in the ambulatory care of the National Health Service (NHS) in England and Wales. In addition, it is discussed whether the NICE approach could be a role model for Germany.Methods:The number of prescription items dispensed and the net ingredient costs of thirty-one drugs reimbursed by the NHS were analyzed, thereof thirteen drugs descriptively and twenty-one drugs with regression analyses. Data were extracted from the “Prescription-Costs-Analysis-Statistics” for the ambulatory care of the British Department of Health (England 1993–2005). In the case of the twenty-one drugs analyzed by regression analyses, predictions were established how the prescribing and the costs would have developed without NICE's drug appraisal. Finally, conclusions were drawn whether NICE's negative and restricting drug appraisals had a decreasing effect or not.Results:For 97 percent of the drugs analyzed in this study, the publication of NICE's fourteen negative and restricting technology appraisals of drugs between 2000 and 2004 did not reduce the number of prescription items dispensed and net ingredient costs in the ambulatory care of the NHS in England and Wales.Conclusions:Cost-effectiveness appraisals as performed by NICE or the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) are a useful and important tool to enhance the discussion about methods and acceptance of evidence-based medicine in general.

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Quantifying the impact of delayed delivery of cardiac rehabilitation on patients’ health

European Journal of Preventive Cardiology ◽

10.1177/2047487320912625 ◽

2020 ◽

Vol 27 (16) ◽

pp. 1775-1781

Author(s):

Sebastian Hinde ◽

Alexander Harrison ◽

Laura Bojke ◽

Patrick Doherty

Keyword(s):

National Health Service ◽

Health Service ◽

Life Expectancy ◽

Cardiac Rehabilitation ◽

National Health ◽

Average Lifetime ◽

National Guidelines ◽

Patient Health ◽

The Impact

Background Despite its role as an effective intervention to improve the long-term health of patients with cardiovascular disease and existence of national guidelines on timeliness, many health services still fail to offer cardiac rehabilitation in a timely manner after referral. The impact of this failure on patient health and the additional burden on healthcare providers in an English setting is quantified in this article. Methods Two logistic regressions are conducted, using the British Heart Foundation National Audit of Cardiac Rehabilitation dataset, to estimate the impact of delayed cardiac rehabilitation initiation on the level of uptake and completion. The results of these regressions are applied to a decision model to estimate the long-term implications of these factors on patient health and National Health Service expenditure. Results We demonstrate that the failure of 43.6% of patients in England to start cardiac rehabilitation within the recommended timeframe results in a 15.3% reduction in uptake, and 7.4% in completion. These combine to cause an average lifetime loss of 0.08 years of life expectancy per person. Scaled up to an annual cohort this implies 10,753 patients not taking up cardiac rehabilitation due to the delay, equating to a loss of 3936 years of life expectancy. We estimate that an additional £12.3 million of National Health Service funding could be invested to alleviate the current delay. Conclusions The current delay in many patients starting cardiac rehabilitation is causing quantifiable and avoidable harm to their long-term health; policy and research must now look at both supply and demand solutions in tackling this issue.

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