Association Between Age Older Than 75 Years and Exceeded Target Waiting Times in the Emergency Department: A Multicenter Cross-Sectional Survey in the Paris Metropolitan Area, France

Freund, Yonathan; Vincent-Cassy, C.; Bloom, Ben; Riou, Bruno; Ray, Patrick

doi:10.1016/j.annemergmed.2013.04.017

Cited by 28 publications

(34 citation statements)

References 34 publications

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“…We selected variables of the model a priori based on clinical relevance and previous studies, namely age older than 75 years, relative occupancy of the ED, trauma, severity triage, day of the week and time of the day. 13 In order to explore the association between the level of burnout and the outcome, we included in the model the mean burnout level of physicians working that day in the ED as a dichotomous variable (higher or lower than the median). Adjusted odds ratios (OR) and their 95% confidence intervals (IC) were calculated, and we assessed the best discrimination of the model with the area under the receiving operator characteristic curve (c statistic).…”

Section: Discussionmentioning

confidence: 99%

“…We enrolled all adult patients who attended our ED from January 1, 2016, to May 1, 2016. As described elsewhere, 13 immediately after entering the ED demographic data are recorded by a clerk and the time of arrival is electronically recorded. Then the patient is assessed by a triage nurse who assigns a severity triage score on a 1 to 5 scale (1 being the most severe), depending on vital parameters, medical history and chief complaint.…”

Section: Designmentioning

confidence: 99%

“…We made the hypothesis that 55% of patients will meet the primary endpoint, as we previously described. 13 With a power of 90% and an alpha of 0.05, we needed to analyze 4700 patients to report an adjusted OR of at least 1.1, which we considered the minimal clinically significant effect (PASS 14, NCSS, LLC.…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…10,11 There are a few previously reported independent predictors of prolonged WT (time of day of the ED visit, age of the patient, overcrowding or daily census for example). [12][13][14][15] However, studies investigating factors associated with a prolonged WT have so far only analyzed factors at the patient level or the ED level, whereas data on the provider (emergency physician) have not been examined.…”

Section: Introductionmentioning

confidence: 99%

“…This is defined as the maximal recommended WT depending on the acuity on a 1 to 5 scale level (respectively 0, 20, 60, 120 and 240 min), as previously described . 13 This severity triage scale is widely used in France and recommended by the French Society of Emergency Medicine. 12,16,17 The goal of this investigation is to assess whether a high level of burnout among physicians working at the ED on a given day is associated with a higher risk of exceeding WT for patients visiting the ED that day.…”

Section: Introductionmentioning

confidence: 99%

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Effect of emergency physician burnout on patient waiting times

et al. 2017

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Objectives: Burnout is common amongst emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Methods:Prospective study in an academic ED. All patients that visited the main ED for a four month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint was an exceeded target waiting time for ED patients. All emergency physicians were surveyed by a psychologist to assess their level of burnout using the Maslach Burnout Inventory. We defined the level of burnout of the day in the ED as the mean burnout level of the physicians working that day (8:30 to the 8:30 the next day). A logistic regression model was performed to assess whether burnout level of the day was independently associated with prolonged waiting times, along with previously reported predictors.Results: Target waiting time was exceeded in 7,524 patients (59%). Twenty six emergency physicians were surveyed. Median burnout score was 35 (Interquartile [24-49]). A burnout level of the day higher than 35 was independently associated with an exceeded target waiting time (adjusted odds ratio 1.54, 95% confidence interval 1.39 to 1.70), together with previously reported predictors (i.e. day of the week, time of the day, trauma, age and daily census).

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Section: Discussionmentioning

confidence: 99%

Section: Designmentioning

confidence: 99%

Section: Sample Size Calculationmentioning

confidence: 99%