Is the emergency department safe? Patients and experts think so
The emergency department (ED) is currently an unsafe place for both professionals and patients, according to the results of an international survey conducted for the European Emergency Society (EUSEM) and published today ( May 26) in the magazine European Journal of Emergency Medicine. The main reason for this is understaffing and overcrowding due to the unavailability of beds in the wards where care needs to be provided in the corridors. Survey respondents also feel that they do not have enough support from hospital management.
Approximately 90% of professionals surveyed feel that sometimes the number of patients in the ED exceeds the capacity of the department to provide safe care and that such overcrowding is a frequent problem. In addition to being uncomfortable for patients and professionals, and hindering their ability to provide care, overcrowding is known to pose a significant risk of harm and increased mortality.
The initial findings of a survey among the patients, unpublished, is even more alarming. Many patients think that the ED staff member is “angry” or “rude” rather than kind. This may be due to burnout and frustration, according to an accompanying editorial by EUEM President Dr James Connolly, “as the vast majority of respondents to the experts’ survey said they were proud. be working in the ED.” Among the responses received, a typical response was “There are many patients and very few doctors. Some nurses are very stressed.”
Indeed, the nurses who responded to the survey felt less safe than doctors, especially in terms of the environment they had to treat patients with mental health issues. Because they generally work with patients for longer periods of time, this is understandable, but troubling nonetheless, the researchers say.
“Last year’s EUSEM survey of burnout among ED professionals was worrying enough,” says Dr. Connolly, suggesting that younger and less experienced EM professionals are more likely to be affected. benefits than older, more experienced employees. We see this pattern over and over again, and it is completely unacceptable that very little action has been taken to correct it. If so, the situation is likely to be worse than before.” This is especially important, since in many emergency departments the majority of specialists are still less experienced and therefore at higher risk of burnout. therefore need more supervision to protect both themselves and their patients.
While goals have been beneficial in delivering improvements in the past, current feedback from ED staff suggests that when systems are under significant stress, they feel pressured by the imposition of pressure. setting such external goals, and they believe this may compromise patient care. . About 54.2% said they are often under pressure from outside. Support from hospital management is also said to be inadequate; 35% of professional respondents responded that hospital managers were never supportive of the introduction of improvements, and 47% thought that flow improvement processes in ED were never effective.
Alarmingly, some of the patients surveyed felt so worried about their safety in the ED that they said they didn’t want to go there at all, believing that WinterLong wait times and employee burnout will lead to medical errors.
“Devoted experts need the right environment and support to do their jobs, and patients need to feel reassured that they will get the best treatment. We are far from that right now. Governments and health authorities must fix this now, before the situation worsens when it may become too late to stop the downward spiral,” said Dr Connolly.
Roberta Petrino et al., Patient safety in the emergency department: a problem for the health care system? international survey, European Journal of Emergency Medicine (2023). DOI: 10.1097/MEJ.0000000000001044
Jim Connolly, Safety Mindset, European Journal of Emergency Medicine (2023). DOI: 10.1097/MEJ.0000000000001048
Provided by the European Society of Emergency Medicine (EUSEM)
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