فهرست مطالب sophia aguirre

The clinical diversity of patients presenting to the emergency department (ED) allows emergencymedicine (EM) and non-EM residents to sharpen their clinical skills. In most EDs, residents self-assign pa-tients at their discretion. Our institution transitioned from a self-assignment-system to an automated-system,after which we sought to determine the productivity of our non-EM residents compared to the previous system.

In this retrospective cross-sectional study, resident productivity was measured as number of patientvisits per hour and per 8.5-hour shift before and after the implementation of an automated patient assignmentsystem in emergency department. The automated-system assigns one patient at the start of the shift, another30 minutes later, and one patient every hour thereafter, throughout the shift.

28 residents performed406 total shifts prior to implementation and 14 residents performed 252 total shifts post-implementation. Theaverage number of patient visits per hour significantly increased from 0.52 ± 0.18 (95% CI 0.45-0.59, IQR 0.43-0.60) to 0.82 ± 0.11 (95% CI 0.75-0.88, IQR 0.74-0.89) after implementation of our assignment system (p<0.00001;figure 1). Additionally, the average number of patient visits per 8.5-hour shift significantly increased from 4.46± 1.53 (CI 3.86-5.05, IQR 3.66-5.08) to 6.52 ± 0.86 (CI 6.02-7.02, IQR 5.90-7.09) after the implementation of oursystem (p<0.00001; figure 1).

These findings warrant further evaluation of the impact of patientassignment systems on trainee education.

To investigate in how the current COVID-19 pandemic affects patient’s perceptions of emergency physician empathy and communication. Patients cared for by Emergency Department physicians with the lowest satisfaction scores were surveyed within one week of discharge via phone. Using questions from the Consultation and Relational Empathy (CARE) survey, patients rated their satisfaction with their Emergency provider’s empathy and communication on a scale of 1 to 5 and provided feedback on how the patient-provider interaction could be improved. Demographic data and patient responses to CARE survey questions were compared between preCOVID-19 and during COVID-19 time. Patient’s open-ended responses were analyzed for themes related to the impact of COVID-19 on the patient-provider relationship. Patient median quantitative scores were 5 (4-5) across all five questions of pre-COVID-19 and 5 (4-5) during COVID-19 for all questions except two (showing care and compassion), median 5(5-5). Female patients rated provider empathy and communication lower than mens. There was no differences across age strata. A shift in provider focuses to COVID-19 only care (N=3), and an understanding of the stress on healthcare processes (N=13) from open-ended responses themes emerged of patients who want to minimize interactions within the emergency department (N=3). The external factor of the current pandemic did not negatively impact patient’s satisfaction scores. Many patients express leniency and gratitude for emergency providers during this challenging time. Their responses seem to mirror current societal views of frontline healthcare workers.