Making PROGRESS – Pediatric Emergencies and Healthcare Disparities
Spoon Feed
This systematic review and meta-analysis identified multiple social determinants of health that were related to increased utilization of ED services by children from racial minority and lower socioeconomic status (SES) groups.
Source
Social Determinants of Health and Pediatric Emergency Department Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Ann Emerg Med. Published online December 6, 2023. doi:10.1016/j.annemergmed.2023.10.010
Simplest Way to Boost Patient Satisfaction? You Might Want to Sit Down for This…
Spoon Feed
Chair placement near the bedside is a simple intervention that increased the likelihood of physician sitting during patient encounters and yielded higher patient scores in satisfaction and communication.
Source
Effect of chair placement on physicians' behavior and patients' satisfaction: randomized deception trial. BMJ. 2023;383:e076309. Published 2023 Dec 15. doi:10.1136/bmj-2023-076309.
The Real Risks of Boarding in the Emergency Department
Please read this announcement about upgrades to JournalFeed (CME, Amal Mattu, new website)! We also need to do a price increase due to rising costs. Price changes started Dec. 1, 2023 for new subscribers and on Jan 1, 2024 for current subscriber auto-renewals. If cost is a barrier for you, please read the announcement. We want to help! ~Clay Smith
Spoon Feed
In this large, multicenter prospective cohort study in France, researchers found that patients ≥75 years who were admitted overnight boarding in the ED had higher rates of in-hospital mortality, length of stay, and adverse events.
Source
Overnight Stay in the Emergency Department and Mortality in Older Patients. JAMA Intern Med. 2023 Dec 1;183(12):1378-1385. doi: 10.1001/jamainternmed.2023.5961.
Does Contact Precaution for MRSA Really Matter?
Spoon Feed
Contact precaution (CP) for patients with MRSA infection or colonization is listed as an "essential practice" for all U.S. hospitals, but should it be?
Experienced or Rusty? Physician Age and Patient Mortality
Spoon Feed
Emergency physician (EP) advancing age was associated with higher 7-day patient mortality. This is a call to keep current with literature, clinical skills, and best practices.
Source
Association Between Emergency Physician's Age and Mortality of Medicare Patients Aged 65 to 89 Years After Emergency Department Visit. Ann Emerg Med. 2023 Sep;82(3):301-312. doi: 10.1016/j.annemergmed.2023.02.010. Epub 2023 Mar 23.
Who Gets Sued in EM – NP, PA, Attending, or Resident?
Spoon Feed
In a retrospective analysis of 5,854 emergency department malpractice cases from over 550 US hospitals, 193 (3.3%) involved an NP, 513 (8.8%) involved a PA, 535 (9.1%) involved a trainee, and 4,568 (78.0%) were attending only.
Source
Characterizing malpractice cases involving emergency department advanced practice providers, physicians in training, and attending physicians [published online ahead of print, 2023 Sep 8]. Acad Emerg Med. 2023;10.1111/acem.14800.
How to Identify Errors – “Would You Have Done Something Differently?”
Spoon Feed
Asking EPs the question - “Would you have done something differently? (WYHDSD)” - was found to have high sensitivity (97.4%) and NPV (99.8%) in predicting medical error. Specificity was lower at 92.9%.
Source
Can Asking Emergency Physicians Whether or Not They Would Have Done Something Differently (WYHDSD) be a Useful Screening Tool to Identify Emergency Department Error? J Emerg Med. 2023 Sep;65(3):e250-e255. doi: 10.1016/j.jemermed.2023.05.005. Epub 2023 Jun 10.
Does Suicide Risk Screening…Actually Reduce Suicide?
Spoon Feed
Depression screening (with varying forms of intervention) reduces depression symptoms in follow up, and the screening tools are fairly accurate. Suicide screening (with various interventions) does not reduce suicidal ideation or suicide attempts and may actually increase attempts, though the evidence is very limited.
Source
Depression and Suicide Risk Screening: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2023 Jun 20;329(23):2068-2085. doi: 10.1001/jama.2023.7787.
Leaving So Soon? Why Women Are Retiring from EM Early
Spoon Feed
On average, female EM physicians leave clinical practice 12 years younger than their male counterparts, after fewer years of practice, and the amount of time spent in the workforce is decreasing over time. We need to identify and implement systemic fixes to stop this.
Source
Emergency medicine physician workforce attrition differences by age and gender. Acad Emerg Med. 2023 Jun 14. doi: 10.1111/acem.14764. Online ahead of print.
Teamwork – It’s a Matter of Life and Death
Spoon Feed
There was an increased number of patient deaths on ICU shifts with low nurse-to-nurse familiarity.
Source
Nurse-to-Nurse Familiarity and Mortality in the Critically Ill: A Multicenter Observational Study. Am J Respir Crit Care Med. 2023 Apr 15;207(8):1022-1029. doi: 10.1164/rccm.202204-0696OC.