Improving physicians’ workload, patient flow and patient safety in Emergency Departments Event

Event details

Emergency Departments (EDs) are widely known for their stochastic nature, unpredictable arrivals and overcrowding problems. These can cause stress to physicians that, sustained over time, could lead to medical errors and poor quality medical care for patients. The physicians in a Spanish ED reported that they perceived wide variation and inequity in the stress arising from their assigned workload. A large part of this inequity is due to the patient flow management rule used at triage, which immediately assigns a patient to a physician in a rotational way. The main purpose of our research is to introduce physician stress as a criterion to manage patient flow with a dual purpose: to improve physicians’ working conditions and at the same time improve patients waiting time to first medical consultation. Meeting these objectives requires an assessment of the stress experienced by physicians in real time, which cannot be measured by any existing methods. We have developed a methodology that takes into account the factors reported by physicians as the main causes of the stress they feel: workload (pending patients), uncertainty (unpredictable arrivals or severity of patients not yet seen) and time pressure (overcrowding). This methodology is based on physicians’ ratings of real scenarios, taking into account the workload assigned to a physician broken down by patient type (severity), their stage of medical care process, waiting time targets and teaching duties. The collected scores are the primary data used to estimate our stress assessment function. We have investigated the use of different patient-physician assignment rules that include as a criterion the stress level experienced by physicians. The new rules improve the current situation used in the ED under study. In addition, in my presentation I will introduce my research group DECYL (Data, Statistics, Quality and Logistics) and other problems related with the modelling and improvement of health services we are currently working in.