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Through education and advocacy, we can reduce the risk of global nuclear conflict. You have more power to change the world than you might think.
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Reducing the Risks of Nuclear War-The Role of Health Professionals. JAMA. 2023 Aug 15;330(7):601-602. doi: 10.1001/jama.2023.14519.
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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.
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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.
Spoon Feed
Among Medicaid-enrolled children, rates of outpatient follow-up after discharge from the ED for a mental health (MH) diagnosis are low, particularly for children who are Black, have fee-for-service (vs. capitated) coverage, and without previous outpatient mental health visits.
Source
Follow-up After Pediatric Mental Health Emergency Visits. Pediatrics. 2023 Mar 1;151(3):e2022057383. doi: 10.1542/peds.2022-057383.
Spoon Feed
Though incremental progress has occurred over the last several decades, inequities loom for people that wish to become pregnant during medical training.
Source
Pregnancy and Residency – Overdue for Equity. N Engl J Med. 2023 Mar 16;388(11):966-967. doi: 10.1056/NEJMp2215288. Epub 2023 Mar 11.
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In this Cochrane review, hand-hygiene programs reduce the incidence of clinical acute respiratory illness (ARI), while masking probably does not provide additional benefit.
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Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2023 Jan 30;1(1):CD006207. doi: 10.1002/14651858.CD006207.pub6.
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Diagnostic errors in the ED occur at rates similar to those in other clinical settings. Not all errors have human causes, and not all are inevitable – this article suggests systems-level opportunities for improvement.
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Violence directed at healthcare workers (HCWs) is common in the ED setting. Studies have demonstrated workplace violence is underreported and can have long term effects on HCWs.
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Exploring verbal and physical workplace violence in a large, urban emergency department. Am J Emerg Med. 2023 Jan 27;67:1-4. doi: 10.1016/j.ajem.2023.01.036. Epub ahead of print.
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The Medicare Merit-based Incentive Payment System (MIPS) seems to be ineffective at measuring quality of care and incentivizing quality improvement.
Source
Association Between Individual Primary Care Physician Merit-based Incentive Payment System Score and Measures of Process and Patient Outcomes. JAMA, 328(21), 2136–2146. https://doi.org/10.1001/jama.2022.20619
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Drowning is a common cause of death worldwide. The duration of submersion is the best predictor of outcome, with immediate on-scene CPR and ventilation improving outcomes. Prevention is the best medicine, with public health intervention and policy being the most effective way to prevent drowning.
Source
Prevention of and Emergency Response to Drowning. NEJM 2022 Oct 6. Doi:10.1056/NEJMra2202392
Spoon Feed
A review of actionable standards set forth by the Joint Commission in 2018-2019 showed that the majority of required changes were only partly, or not at all, supported by quality evidence.
Source
The evidence base for US joint commission hospital accreditation standards: cross sectional study. BMJ. 2022 Jun 23;377:e063064. doi: 10.1136/bmj-2020-063064.
