Introduction: Patients seen per hour (PPH) is a popular metric for emergency medicine (EM) resident efficiency, although it likely insufficient encapsulating overall efficiency. In this study we explored the relationship between higher patient complexity, acuity on shift, and markers of clinical Methods: We performed retrospective analysis using electronic health record data patients by EM residents during their final year training who graduated 2017–2020 at single, urban, academic hospital....

Abstract Background The rate of patients who leave without being seen (LWBS) from an emergency department (ED) is a common measurement quality, operational efficiency, and patient satisfaction. We hypothesized that adding nonclinical staff role, guest service ambassadors (GSA), to the ED waiting room would decrease LWBS rates reduce existing differences by race, ethnicity, sex, primary language for patients. Methods conducted observational cohort study at quaternary care academic in...

Experiential learning theory suggests that direct clinical experiences facilitate learning. Previous literature has focused primarily on the of fourth-year medical students. As more students gain early exposure, it is important to understand types patients seen by junior

Our study aims to better understand and describe the current state of diversity, equity, inclusion (DEI) leadership in emergency medicine (EM) by identifying prevalence department DEI positions, their demographics, job duty characteristics.

Numerous studies have identified information overload as a key issue for electronic health records (EHRs). This study describes the amount of text data across all notes available to emergency physicians in EHR, trended over time since EHR establishment.

Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such must be designed fit dynamic work systems of clinicians who use them. We propose academic detailing-personal visits an expert in a specific health IT tool-as method for both ensuring correct understanding tool and its evidence base identifying factors influencing tool's implementation.

Background Emergency department (ED) providers are important collaborators in preventing falls for older adults because they often the first health care to see a patient after fall and at-home preceded by previous ED visits. Previous work has shown that referrals interventions can reduce risk of an 38%. Screening patients at be time-consuming difficult implement setting. Machine learning (ML) clinical decision support (CDS) offer potential automating screening process. However, it remains...

Introduction: SARS-CoV-2, a novel coronavirus, manifests as respiratory syndrome (COVID-19) and is the cause of an ongoing pandemic. The response to COVID-19 in United States has been hampered by overall lack diagnostic testing capacity. To address uncertainty about levels SARS-CoV-2 community transmission early pandemic, we aimed develop surveillance tool using readily available emergency department (ED) operations data extracted from electronic health record (EHR). This involved optimizing...

Introduction: Emergency medicine (EM) residency programs have variable approaches to educating residents on recognizing and managing healthcare disparities. We hypothesized that our curriculum with resident-presented lectures would increase residents’ sense of cultural humility ability identify vulnerable populations. Methods: At a single-site, four-year EM program 16 per year, we designed intervention from 2019-2021 where all second-year selected one disparity topic gave 15-minute...

Since 2018, the Centers for Medicare & Medicaid Services (CMS) guidelines have allowed teaching physicians to bill evaluation and management services based on medical student documentation. Limited previous data suggest that documentation suffers from a high rate of downcoding relative faculty We sought compare coding outcomes performed by students, not edited faculty, with submitted faculty.

Introduction: Emergency medicine (EM) residents take the American Board of Medicine (ABEM) In-Training Examination (ITE) every year. This examination is based on ABEM Model Clinical Practice (Model). The purpose this study was to determine whether a relationship exists between number patient encounters resident sees within specific clinical domain and their ITE performance questions that are related domain. Methods: Chief complaint data for each encounter taken from electronic health record...

Abstract Objective Numerous studies have identified information overload as a key issue for electronic health records (EHRs). This study describes the amount of text data across all notes available to emergency physicians in EHR, trended over time since EHR establishment. Materials and Methods We conducted retrospective analysis from large healthcare system, examining number corresponding total words tokens during patient encounters department (ED). assessed change these metrics 17-year...

To support the ongoing adaptation and implementation of an Emergency Department (ED)-based clinical decision (CDS) tool to prevent future falls, we interviewed older adults ( n = 15) during their ED stay. We elicited feedback on written verbal content existing CDS, feelings about automated risk-screening aspect CDS asked them identify barriers that would from following up with Falls Clinic which supports referral placements. Our findings suggest saw simply as another they trusted...

Abstract Objectives There is a concern that provide increased extraneous cognitive load when paired with residents on shift. However, this may be offset by the decrease in they to are offloading basic patient care tasks. We hypothesized these forces not balanced. Methods conducted retrospective observational analysis of PGY‐2 emergency medicine and junior medical students at single academic department (ED) Midwest. A series efficiency metrics (relative value unit [RVUs], patients per hour...

While many aspects of emergency medicine (EM) residency training are standardized among residents within a single program, there is no standard for the distribution chief complaints (CC) that should see over course residency. This could result in substantial variability each resident's clinical exposure. Our objective this study was to explore EM residents' exposure CCs determine whether variation exists. If such exists, suggest need curricular reform address gaps resident during training....

The purpose of this study was to examine system- and patient-level factors associated with the number healthcare disciplines involved in delivery patient education among hospitalized older cancer survivors.

Abstract Background Existing monitoring of machine-learning-based clinical decision support (ML-CDS) is focused predominantly on the ML outputs and accuracy thereof. Improving patient care requires not only accurate algorithms but also systems that enable output these to drive specific actions by teams, necessitating expanding their monitoring. Objectives In this case report, we describe creation a dashboard allows intervention development team operational stakeholders govern identify...

Abstract Background Significant concerns have been raised regarding antibiotic exposure in patients with COVID-19 and the impact of pandemic on antimicrobial stewardship acute care setting. Therefore, we assessed trends inpatient prescribing practices for symptomatic non-COVID-19 respiratory tract infections (RTIs). Methods We identified non-elective, observation admissions from March 2020 – December 2022 RTIs at 765 hospitals Premier Healthcare Database using an ICD-10 code algorithm....

<sec> <title>BACKGROUND</title> Emergency department (ED) providers are important collaborators in preventing falls for older adults because they often the first health care to see a patient after fall and at-home preceded by previous ED visits. Previous work has shown that referrals interventions can reduce risk of an 38%. Screening patients at be time-consuming difficult implement setting. Machine learning (ML) clinical decision support (CDS) offer potential automating screening process....

<sec> <title>BACKGROUND</title> Clinical decision support (CDS) tools that incorporate machine learning–derived content have the potential to transform clinical care by augmenting clinicians’ expertise. To realize this potential, such must be designed fit dynamic work systems of clinicians who use them. We propose academic detailing—personal visits an expert in a specific health IT tool—as method for both ensuring correct understanding tool and its evidence base identifying factors...

Introduction: Rocuronium has replaced succinylcholine as the neuromuscular blockade (NMB) agent of choice for rapid sequence induction (RSI) in emergency department (ED) & ICU. Sugammadex, a specific NMB reversal which is used extensively operating rooms (ORs) and surgical ICUs, remains underutilized EDs. Meanwhile, incidence awareness with paralysis (AWP), complication NMB, 10-100x greater among mechanically ventilated ED patients compared to OR patients. An algorithmic approach use...