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Erschienen in: Internal and Emergency Medicine 3/2018

04.07.2017 | EM - ORIGINAL

Effect of emergency physician burnout on patient waiting times

verfasst von: Carla De Stefano, Anne-Laure Philippon, Evguenia Krastinova, Pierre Hausfater, Bruno Riou, Frederic Adnet, Yonathan Freund

Erschienen in: Internal and Emergency Medicine | Ausgabe 3/2018

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Abstract

Burnout is common in emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Prospective study in an academic ED. All patients who visited the main ED for a 4-month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint was an exceeded target waiting time for ED patients. All emergency physicians were surveyed by a psychologist to assess their level of burnout using the Maslach Burnout Inventory. We defined the level of burnout of the day in the ED as the mean burnout level of the physicians working that day (8:30 to the 8:30 the next day). A logistic regression model was performed to assess whether burnout level of the day was independently associated with prolonged waiting times, along with previously reported predictors. Target waiting time was exceeded in 7524 patients (59%). Twenty-six emergency physicians were surveyed. Median burnout score was 35 [Interquartile (24–49)]. A burnout level of the day higher than 35 was independently associated with an exceeded target waiting time (adjusted odds ratio 1.54, 95% confidence interval 1.39–1.70), together with previously reported predictors (i.e., day of the week, time of the day, trauma, age and daily census). Burnout of emergency physicians was independently associated with a prolonged waiting time for patients visiting the ED.
Literatur
2.
Zurück zum Zitat Spickard A, Gabbe SG, Christensen JF (2002) Mid-career burnout in generalist and specialist physicians. JAMA 288(12):1447–1450CrossRefPubMed Spickard A, Gabbe SG, Christensen JF (2002) Mid-career burnout in generalist and specialist physicians. JAMA 288(12):1447–1450CrossRefPubMed
4.
Zurück zum Zitat Dyrbye LN, Thomas MR, Massie FS et al (2008) Burnout and suicidal ideation among US medical students. Ann Intern Med 149(5):334–341CrossRefPubMed Dyrbye LN, Thomas MR, Massie FS et al (2008) Burnout and suicidal ideation among US medical students. Ann Intern Med 149(5):334–341CrossRefPubMed
6.
Zurück zum Zitat Pines JM, Pollack CV Jr, Diercks DB, Chang AM, Shofer FS, Hollander JE (2009) The association between emergency department crowding and adverse cardiovascular outcomes in patients with chest pain. Acad Emerg Med Off J Soc Acad Emerg Med 16(7):617–625. doi:10.1111/j.1553-2712.2009.00456.x CrossRef Pines JM, Pollack CV Jr, Diercks DB, Chang AM, Shofer FS, Hollander JE (2009) The association between emergency department crowding and adverse cardiovascular outcomes in patients with chest pain. Acad Emerg Med Off J Soc Acad Emerg Med 16(7):617–625. doi:10.​1111/​j.​1553-2712.​2009.​00456.​x CrossRef
7.
Zurück zum Zitat Mills AM, Shofer FS, Chen EH, Hollander JE, Pines JM (2009) The association between emergency department crowding and analgesia administration in acute abdominal pain patients. Acad Emerg Med Off J Soc Acad Emerg Med. 16(7):603–608. doi:10.1111/j.1553-2712.2009.00441.x CrossRef Mills AM, Shofer FS, Chen EH, Hollander JE, Pines JM (2009) The association between emergency department crowding and analgesia administration in acute abdominal pain patients. Acad Emerg Med Off J Soc Acad Emerg Med. 16(7):603–608. doi:10.​1111/​j.​1553-2712.​2009.​00441.​x CrossRef
8.
Zurück zum Zitat Guttmann A, Schull MJ, Vermeulen MJ, Stukel TA (2011) Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada. BMJ 342:d2983CrossRefPubMedPubMedCentral Guttmann A, Schull MJ, Vermeulen MJ, Stukel TA (2011) Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada. BMJ 342:d2983CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Plunkett PK, Byrne DG, Breslin T, Bennett K, Silke B (2011) Increasing wait times predict increasing mortality for emergency medical admissions. Eur J Emerg Med Off J Eur Soc Emerg Med. 18(4):192–196. doi:10.1097/MEJ.0b013e328344917e CrossRef Plunkett PK, Byrne DG, Breslin T, Bennett K, Silke B (2011) Increasing wait times predict increasing mortality for emergency medical admissions. Eur J Emerg Med Off J Eur Soc Emerg Med. 18(4):192–196. doi:10.​1097/​MEJ.​0b013e328344917e​ CrossRef
13.
Zurück zum Zitat Freund Y, Vincent-Cassy C, Bloom B, Riou B, Ray P, APHP Emergency Database Study Group (2013) Association between age older than 75 years and exceeded target waiting times in the emergency department: a multicenter cross-sectional survey in the Paris metropolitan area, France. Ann Emerg Med 62(5):449–456. doi:10.1016/j.annemergmed.2013.04.017 CrossRefPubMed Freund Y, Vincent-Cassy C, Bloom B, Riou B, Ray P, APHP Emergency Database Study Group (2013) Association between age older than 75 years and exceeded target waiting times in the emergency department: a multicenter cross-sectional survey in the Paris metropolitan area, France. Ann Emerg Med 62(5):449–456. doi:10.​1016/​j.​annemergmed.​2013.​04.​017 CrossRefPubMed
16.
Zurück zum Zitat Sauvin G, Freund Y, Saïdi K, Riou B, Hausfater P (2013) Unscheduled return visits to the emergency department: consequences for triage. Acad Emerg Med Off J Soc Acad Emerg Med 20(1):33–39CrossRef Sauvin G, Freund Y, Saïdi K, Riou B, Hausfater P (2013) Unscheduled return visits to the emergency department: consequences for triage. Acad Emerg Med Off J Soc Acad Emerg Med 20(1):33–39CrossRef
17.
Zurück zum Zitat Capuano F, Lot A-S, Sagnes-Raffy C et al (2014) Factors associated with the length of stay of patients discharged from emergency department in France. Eur J Emerg Med Off J Eur Soc Emerg Med. doi:10.1097/MEJ.0000000000000109 Capuano F, Lot A-S, Sagnes-Raffy C et al (2014) Factors associated with the length of stay of patients discharged from emergency department in France. Eur J Emerg Med Off J Eur Soc Emerg Med. doi:10.​1097/​MEJ.​0000000000000109​
18.
Zurück zum Zitat von Elm E, Altman DG, Egger M et al (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596):1453–1457. doi:10.1016/S0140-6736(07)61602-X CrossRef von Elm E, Altman DG, Egger M et al (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596):1453–1457. doi:10.​1016/​S0140-6736(07)61602-X CrossRef
19.
Zurück zum Zitat Gorlicki J, Raynal P-A, Leleu A, Riou B, Ray P, Freund Y (2015) Reliability of electronic recording of waiting times in the emergency department: a prospective multicenter study. Eur J Emerg Med Off J Eur Soc Emerg Med. 22(5):366–369. doi:10.1097/MEJ.0000000000000232 CrossRef Gorlicki J, Raynal P-A, Leleu A, Riou B, Ray P, Freund Y (2015) Reliability of electronic recording of waiting times in the emergency department: a prospective multicenter study. Eur J Emerg Med Off J Eur Soc Emerg Med. 22(5):366–369. doi:10.​1097/​MEJ.​0000000000000232​ CrossRef
20.
21.
Zurück zum Zitat Maslach C, Jackson SE (1986) Maslach Burnout Inventory, 2nd edn. Consulting Psychologists Press, Palo Alto Maslach C, Jackson SE (1986) Maslach Burnout Inventory, 2nd edn. Consulting Psychologists Press, Palo Alto
22.
Zurück zum Zitat Spielberger CD (1989) State-trait anxiety inventory: a comprehensive bibliography. Consulting Psychologists Press. Palo Alto Spielberger CD (1989) State-trait anxiety inventory: a comprehensive bibliography. Consulting Psychologists Press. Palo Alto
24.
Zurück zum Zitat Spaite DW, Bartholomeaux F, Guisto J et al (2002) Rapid process redesign in a university-based emergency department: decreasing waiting time intervals and improving patient satisfaction. Ann Emerg Med 39(2):168–177CrossRefPubMed Spaite DW, Bartholomeaux F, Guisto J et al (2002) Rapid process redesign in a university-based emergency department: decreasing waiting time intervals and improving patient satisfaction. Ann Emerg Med 39(2):168–177CrossRefPubMed
26.
Zurück zum Zitat de Oliveira GS, Chang R, Fitzgerald PC et al (2013) The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesth Analg 117(1):182–193. doi:10.1213/ANE.0b013e3182917da9 CrossRefPubMed de Oliveira GS, Chang R, Fitzgerald PC et al (2013) The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesth Analg 117(1):182–193. doi:10.​1213/​ANE.​0b013e3182917da9​ CrossRefPubMed
28.
Zurück zum Zitat Garrouste-Orgeas M, Perrin M, Soufir L et al (2015) The Iatroref study: medical errors are associated with symptoms of depression in ICU staff but not burnout or safety culture. Intensive Care Med 41(2):273–284. doi:10.1007/s00134-014-3601-4 CrossRefPubMed Garrouste-Orgeas M, Perrin M, Soufir L et al (2015) The Iatroref study: medical errors are associated with symptoms of depression in ICU staff but not burnout or safety culture. Intensive Care Med 41(2):273–284. doi:10.​1007/​s00134-014-3601-4 CrossRefPubMed
Metadaten
Titel
Effect of emergency physician burnout on patient waiting times
verfasst von
Carla De Stefano
Anne-Laure Philippon
Evguenia Krastinova
Pierre Hausfater
Bruno Riou
Frederic Adnet
Yonathan Freund
Publikationsdatum
04.07.2017
Verlag
Springer International Publishing
Erschienen in
Internal and Emergency Medicine / Ausgabe 3/2018
Print ISSN: 1828-0447
Elektronische ISSN: 1970-9366
DOI
https://doi.org/10.1007/s11739-017-1706-9

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