Inappropriate ED visits: patient responsibility or an attribution bias?

Chaiyachati, Krisda H.; Kangovi, Shreya

doi:10.1136/bmjqs-2019-009729

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…One way to interpret safety behaviors during the pandemic is through an understanding of attribution bias and naïve realism. Attribution bias is the tendency to attribute others’ behaviors to their character rather than their circumstances 16 , 17 . Attribution bias stems from naïve realism, which is a tendency to believe that we see the world rationally and objectively, and those who behave otherwise must be mis-informed or irrational 18 .…”

Section: Discussionmentioning

confidence: 99%

Mask use among health care workers and feelings of safety at work pre- and post- COVID-19 vaccine

O'Donohue

Fletcher-Gutowski

Sidhu

et al. 2022

American Journal of Infection Control

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Section: Discussionmentioning

confidence: 99%

Mask use among health care workers and feelings of safety at work pre- and post- COVID-19 vaccine

O'Donohue

Fletcher-Gutowski

Sidhu

et al. 2022

American Journal of Infection Control

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“…System-level issues are challenging to address without significant community-based interventions,35 broad healthcare reform, and changes to public policies 36. Despite these challenges, efforts to raise awareness of the myriad societal factors driving people to use the ED may prove helpful in reducing negative emotions and biased judgements of these patients 37.…”

Section: Discussionmentioning

confidence: 99%

What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care

et al. 2020

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BackgroundDespite calls to study how healthcare providers’ emotions may impact patient safety, little research has addressed this topic. The current study aimed to develop a comprehensive understanding of emergency department (ED) providers’ emotional experiences, including what triggers their emotions, the perceived effects of emotions on clinical decision making and patient care, and strategies providers use to manage their emotions to reduce patient safety risks.MethodsEmploying grounded theory, we conducted 86 semi-structured qualitative interviews with experienced ED providers (45 physicians and 41 nurses) from four academic medical centres and four community hospitals in the Northeastern USA. Constant comparative analysis was used to develop a grounded model of provider emotions and patient safety in the ED.ResultsED providers reported experiencing a wide range of emotions in response to patient, hospital, and system-level factors. Patients triggered both positive and negative emotions; hospital and system-level factors largely triggered negative emotions. Providers expressed awareness of possible adverse effects of negative emotions on clinical decision making, highlighting concerns about patient safety. Providers described strategies they employ to regulate their emotions, including emotional suppression, distraction, and cognitive reappraisal. Many providers believed that these strategies effectively guarded against the risk of emotions negatively influencing their clinical decision making.ConclusionThe role of emotions in patient safety is in its early stages and many opportunities exist for researchers, educators, and clinicians to further address this important issue. Our findings highlight the need for future work to (1) determine whether providers’ emotion regulation strategies are effective at mitigating patient safety risk, (2) incorporate emotional intelligence training into healthcare education, and (3) shift the cultural norms in medicine to support meaningful discourse around emotions.

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“…It should be highlighted that not all ED visits represent real emergencies, and inappropriate accesses to ED are a well-known issue related to several reasons [7,[24][25][26]. That being said, the observed reduction of the less severe triage codes was to somewhat expected, although not to this large extent.…”

Section: Plos Onementioning

confidence: 99%

Non-COVID-19 patients in times of pandemic: Emergency department visits, hospitalizations and cause-specific mortality in Northern Italy

et al. 2021

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The COVID-19 pandemic forced healthcare services organization to adjust to mutating healthcare needs. Not exhaustive data are available on the consequences of this on non-COVID-19 patients. The aim of this study was to assess the impact of the pandemic on non-COVID-19 patients living in a one-million inhabitants’ area in Northern Italy (Bologna Metropolitan Area-BMA), analyzing time trends of Emergency Department (ED) visits, hospitalizations and mortality. We conducted a retrospective observational study using data extracted from BMA healthcare informative systems. Weekly trends of ED visits, hospitalizations, in- and out-of-hospital, all-cause and cause-specific mortality between December 1st, 2019 to May 31st, 2020, were compared with those of the same period of the previous year. Non-COVID-19 ED visits and hospitalizations showed a stable trend until the first Italian case of COVID-19 has been recorded, on February 19th, 2020, when they dropped simultaneously. The reduction of ED visits was observed in all age groups and across all severity and diagnosis groups. In the lockdown period a significant increase was found in overall out-of-hospital mortality (43.2%) and cause-specific out-of-hospital mortality related to neoplasms (76.7%), endocrine, nutritional and metabolic (79.5%) as well as cardiovascular (32.7%) diseases. The pandemic caused a sudden drop of ED visits and hospitalizations of non-COVID-19 patients during the lockdown period, and a concurrent increase in out-of-hospital mortality mainly driven by deaths for neoplasms, cardiovascular and endocrine diseases. As recurrencies of the COVID-19 pandemic are underway, the scenario described in this study might be useful to understand both the population reaction and the healthcare system response at the early phases of the pandemic in terms of reduced demand of care and systems capability in intercepting it.

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Inappropriate ED visits: patient responsibility or an attribution bias?

Cited by 5 publications

References 14 publications

Mask use among health care workers and feelings of safety at work pre- and post- COVID-19 vaccine

Mask use among health care workers and feelings of safety at work pre- and post- COVID-19 vaccine

What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care

Non-COVID-19 patients in times of pandemic: Emergency department visits, hospitalizations and cause-specific mortality in Northern Italy

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