Four‐hour access targets for emergency departments: Potential negative implications for the work practices and clinical training of junior doctors

Emergency department overcrowding, mortality and the 4‐hour rule in Western Australia

“…Increasingly, they have had to change their practice, with more admissions and investigations occurring on the wards rather than in the EDs. A survey of junior medical staff in WA also illustrated their concerns regarding reduced opportunities for training in patient safety 21 …”

Predicting and preventing peripheral intravenous cannula insertion failure in the emergency department: Clinician ‘gestalt’ wins again

“…The ED is widely regarded as a clinical environment where junior clinicians develop procedural competency in a real‐world setting . In addition, PIVC insertion is often considered a simple task and a poor use of senior clinician time.…”

“…3,5,[9][10][11] The ED is widely regarded as a clinical environment where junior clinicians develop procedural competency in a real-world setting. [12][13][14][15][16] In addition, PIVC insertion is often considered a simple task and a poor use of senior clinician time. As a result of both these factors, PIVC insertion is frequently allocated to junior practitioners.…”

Barriers to the 4‐h rule: What causes delays for gynaecology patients in the emergency department?

“…Nonspecific strategies that merely force staff to process patients faster have proven to be ineffective in achieving compliance and may risk increased occupational stress . Nonspecific strategies are also unlikely to help achieve compliance within specialist areas such as gynaecology within large general hospitals.…”