Multitasking behaviors and provider outcomes in emergency department physicians: two consecutive, observational and multi-source studies

Augenstein, Tobias; Schneider, Anna; Wehler, Markus; Weigl, Matthias

doi:10.1186/s13049-020-00824-8

Cited by 16 publications

(8 citation statements)

References 59 publications

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“…The working model in the ED has classically been described as multitasking, with frequent interruptions a major consequence [30]. This last aspect was recognized by the respondents as a factor affecting safety [31]. Our survey confirmed the relevance of such interruptions; 54.4% of respondents reported that interruptions always disrupted the ability of staff to provide care.…”

Section: Discussionsupporting

confidence: 68%

Patient safety in emergency departments: a problem for health care systems? An international survey

Petrino

Tuunainen

Bruzzone

et al. 2023

European Journal of Emergency Medicine

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Background and importance Patient safety in healthcare is one of the cornerstones of quality of care. The emergency department (ED) is by its very nature a place where errors and safety issues are liable to occur. ConclusionThis survey highlighted that most health professionals identify the ED as an environment with specific safety issues. The main factors appeared to be a shortage of personnel during busy periods, overcrowding due to boarding, and a perceived lack of support from hospital management.

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Section: Discussionsupporting

confidence: 68%

Patient safety in emergency departments: a problem for health care systems? An international survey

Petrino

Tuunainen

Bruzzone

et al. 2023

European Journal of Emergency Medicine

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“…Emergency physicians determine the need for admission based upon a complex interaction of clinical and psychosocial factors, response to therapy and judgement 22 while often multitasking and working in a challenging environment 24 . Cognitive errors and poor decision‐making can occur 25 and the use of predictive algorithms may reduce the potential for error while improving patient safety 26 .…”

Section: Discussionmentioning

confidence: 99%

Early prediction of hospital admission of emergency department patients

Kishore

Braitberg

Holmes

et al. 2023

Emerg Medicine Australasia

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Objective: The early prediction of hospital admission is important to ED patient management. Using available electronic data, we aimed to develop a predictive model for hospital admission. Methods: We analysed all presentations to the ED of a tertiary referral centre over 7 years. To our knowledge, our data set of nearly 600 000 presentations is the largest reported. Using demographic, clinical, socioeconomic, triage, vital signs, pathology data and keywords in electronic notes, we trained a machine learning (ML) model with presentations from 2015 to 2020 and evaluated it on a held-out data set from 2021 to mid-2022. We assessed electronic medical records (EMRs) data at patient arrival (baseline), 30, 60, 120 and 240 min after ED presentation. Results:The training data set included 424 354 data points and the validation data set 53 403. We developed and trained a binary classifier to predict inpatient admission. On a held-out test data set of 121 258 data points, we predicted admission with 86% accuracy within 30 min of ED presentation with 94% discrimination. All models for different time points from ED presentation produced an area under the receiver operating characteristic curve (AUC) ≥0.93 for admission overall, with sensitivity/specificity/ F1-scores of 0.83/0.90/0.84 for any inpatient admission at 30 min after presentation and 0.81/0.92/0.84 at baseline. The models retained lower but still high AUC levels when separated for short stay units or inpatient admissions. Conclusion:We combined available electronic data and ML technology to achieve excellent predictive performance for subsequent hospital admission. Such prediction may assist with patient flow.

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“…A 2021 study found that ED physicians engaged between 13% and 19% of their work time in multitasking. After controlling for ED workload, they found that physicians who engaged more frequently in multitasking perceived higher work stress [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A Simulated Scenario to Improve Resident Efficiency in an Emergency Department

Walker

Elahi

Slome

et al. 2021

Cureus

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Introduction Multitasking is a core competency in emergency medicine. Simulation has been shown to be an effective method of education, which allows learners to prepare for real-world challenges in a controlled environment. Methods In this study, trainees were given a scenario that simulated the experience of managing two patient encounters within a time metric while addressing interruptions that take place in a typical ED. Residents were evaluated using an internally developed scoresheet, which assessed task-switching abilities, documentation skills, and adherence to door to disposition time metric. Residents were asked to evaluate their experience with a survey. Results All the participants reported that they would translate some of the skills learned to their daily clinical practice. Five out of six residents reported improvements in their skills as a result of the task-switching training. The following three common themes were pervasive in the debrief discussion: (1) the residents felt the added pressure of the door-to-disposition metric, (2) the objectives of the simulation did not fit within their pre-constructed concept of a successful simulation equating to establishing the correct diagnosis, and (3) the interruptions were very realistic. Discussion Emergency physicians are interrupted approximately every 9-14 minutes, and this number increases with the number of patients being managed simultaneously. By developing a safe, simulated training environment, we sought to transfer key strategies for improving focus and learning to prioritize while also helping them to identify how certain pressures and interruptions affected their stress levels and concentration.

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Multitasking behaviors and provider outcomes in emergency department physicians: two consecutive, observational and multi-source studies

Cited by 16 publications

References 59 publications

Patient safety in emergency departments: a problem for health care systems? An international survey

Patient safety in emergency departments: a problem for health care systems? An international survey

Early prediction of hospital admission of emergency department patients

A Simulated Scenario to Improve Resident Efficiency in an Emergency Department

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