High‐efficiency Practices of Residents in an Academic Emergency Department: A Mixed‐methods Study

Egan, Haley M.; Ilko, Steven A.; Pomeranz, Kaila; Mohr, Nicholas M.; Ahmed, Azeemuddin

doi:10.1002/aet2.10517

Cited by 2 publications

(3 citation statements)

References 21 publications

(53 reference statements)

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“…Our findings build on existing literature that describes strategies for teaching ED flow, particularly for medical residents [ 8 – 14 ]. This literature emphasizes the importance of teaching management and leadership skills necessary for improving patient flow and efficiency through constructive feedback, leading by example, and providing opportunities for residents to discuss and practice patient flow management.…”

Section: Discussionsupporting

confidence: 67%

“…In addition to the gap in flow training for ED staff, limited academic literature outlines the specific concepts and strategies that should be employed in ED flow training. Existing literature has begun to address this gap by identifying and describing strategies for teaching ED flow, primarily to medical residents [ 9 – 14 ]. However, there is a need to identify a comprehensive list of topics and training methods for flow training for ED staff, including emergency physicians, nurse practitioners, nurses, and medical learners.…”

Section: Introductionmentioning

confidence: 99%

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Identifying relevant topics and training methods for emergency department flow training

Young

Patey²,

Norman³

et al. 2022

Can J Emerg Med

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Purpose Despite the importance of patient flow to emergency department (ED) management, there is a need to strengthen and expand training in flow strategies for practicing ED staff. To date, there has been limited academic inquiry into the skills and training that ED staff require to improve patient flow. As part of a quality improvement initiative, our team aimed to identify the topics and training methods that should be included in flow training for ED staff. Methods We conducted an integrative review and modified Delphi. For the integrative review, we sought to identify appropriate skills, training strategies, and training modalities to include in a curriculum for ED staff. The findings from the review were compiled and distributed to Canadian experts in ED efficiency through a modified Delphi, including physicians, nurses, and nurse practitioners. Results Our literature search retrieved 8359 articles, of which 46 were included in the review. We identified 19 skills, 9 training strategies, and 12 training modalities used to improve ED efficiency in the literature. For the modified Delphi, we received responses from 39 participants in round one and 28 in round two, with response rates of 57% and 41%, respectively. The topics chosen by the most respondents were: “flow decisions,” “teamwork,” “backlog and surge management,” “leadership,” and “situational awareness.” Conclusion Our findings suggest that flow training should teach ED staff how to make decisions that improve flow, work more effectively as a team, manage patient backlog and surge, improve leadership skills, and develop situational awareness. These findings add to a gap in the academic literature regarding the training ED staff require to improve patient flow.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Identifying relevant topics and training methods for emergency department flow training

Young

Patey²,

Norman³

et al. 2022

Can J Emerg Med

View full text Add to dashboard Cite

show abstract

“…While a number of publications have provided global recommendations for how residents can improve WFE, 3,[18][19][20][21] the specific approaches utilized by residency programs to teach these skills have not been described. Our study identified on-shift feedback as the most popular approach to teaching WFE, reported by 88% of re- While there is an overall paucity of resources on teaching efficiency, there are numerous possible ways this could be accomplished.…”

Section: Discussionmentioning

confidence: 99%

A nationwide survey of emergency medicine resident workflow efficiency: Are training programs teaching residents to be efficient?

Carmelli

Watson

Villarroel

et al. 2021

AEM Education and Training

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Background: Workflow efficiency (WFE) is essential to the practice of emergency medicine (EM), but a standardized approach to measuring and teaching it during residency is lacking. In this study we sought to describe how EM residency programs in the United States currently measure and teach WFE and to assess the relative importance of WFE teaching to EM residency program leaders.Methods: We conducted a cross-sectional survey of all accredited EM residency training programs in the United States in Fall 2019. We invited all allopathic EM residency programs to participate in the study by directly emailing program directors and assistant/associate program directors. We conducted the study and performed descriptive statistics using SurveyMonkey software. Results:We received a total of 133 responses out of 190 total programs (70%) with proportionate representation from 3-and 4-year programs and all regions of the United States. When asked to what extent teaching efficiency should be a priority compared to other educational goals, 65% of program leaders responded with "significant" or "moderate" priority. Most EM programs collect WFE data on their residents, either by tracking patients per hour (78%) or by written evaluations (59%). Common methods for providing WFE data to residents were: "individual data provided along with deidentified rank" (35%), "data provided only during private feedback meetings" (26%), and "no data or rank provided to residents" (16%). Regarding targeted WFE teaching to residents, 88% reported utilizing general on-shift teaching, 48% reported teaching WFE during formal didactics, and 45% during dedicated private feedback sessions. Conclusion:This national study of allopathic U.S. EM programs suggests that most EM program leaders do value WFE teaching. However, we found no consistent approach among programs for tracking or distributing resident WFE data, and many programs lack a formalized way to teach efficiency to their residents.

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High‐efficiency Practices of Residents in an Academic Emergency Department: A Mixed‐methods Study

Cited by 2 publications

References 21 publications

Identifying relevant topics and training methods for emergency department flow training

Identifying relevant topics and training methods for emergency department flow training

A nationwide survey of emergency medicine resident workflow efficiency: Are training programs teaching residents to be efficient?

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