Poster Thumbnail
Association of Medication History With Pain Medication Administration for Abdominal Pain

Ryan Lucas, MPH – Medical Student, Rocky Vista University

Kennon Heard, MD – Professor of Emergency Medicine, University of Colorado Denver-Emergency Medicine

Kennon Heard, MD – Professor of Emergency Medicine, University of Colorado Denver-Emergency Medicine


Background and Objectives: There is significant variation in the treatment of non-specific abdominal pain in the emergency department (ED). Understanding the characteristics of patients who recieve pain medications may provide insight for better treatment. The objective of this study was to identify historical medications (HM) associated with administration of parenteral opioids to patients with abdominal pain.

Methods: A retrospective chart review including adult (age 18-60) emergency department visits with non-specific abdominal pain within a large academic health system. Cases were identified using ICD-10 codes and variables were abstracted from electronic health records. HM were categorized as : antipsychotics, antidepressants, stimulants, opioids, muscle relaxants, gabapentanoids, benzodiazepines, and non-steroidal anti-inflammatory drugs (NSAIDS). We calculated the proportions of patients who received parenteral opioids for each HM and the relative rates (RR) of parenteral opioid administration.

Results: 29,353 ED visits over the study period. The median age was 32 years (range 18-60), 64% were female. 57% were non-Hispanic White, 11% were African American and 22% were Hispanic. Of these patients, 28.3% (n = 8,304) received a parental opioid while 71.7% (n = 21,049) did not. Patients with previously documented opioid prescriptions (35.4%) were more likely to receive parenteral opioids during their ED visit than those without (26.8%; RR 1.3). The same was true for gabapentinoids (44.1% vs. 28.1%; RR 1.6), antidepressants (39.2% vs. 27.8%; RR 1.4), benzodiazepines (38.2% vs. 27.8%; RR 1.4), antipsychotics (36.5% vs. 28.3%; RR 1.3), muscle relaxants (35.2% vs. 28.1%; RR 1.3), and stimulants (33.4% vs. 28.2%; RR 1.2). NSAIDs did not show a similar increase (28.1% vs. 28.3%; RR 1.0).

Conclusion: HM are associated with an increase use of parenteral opioids. Many of these medications are used to manage chronic diseases that predispose individuals to long-term opioid use and abuse including depression, anxiety, psychosis and chronic pain. This study is limited in that there is no method to determine whether increased opioid use associated with certain HM was a result of altered response to pain, altered response to opioids, or provider prescribing bias.



  Print Poster  View Poster
Poster Thumbnail
Predicting Ongoing Opioid Use Among Emergency Department Patients Treated for Back Pain

Kennon Heard, MD – Professor of Emergency Medicine, University of Colorado Denver-Emergency Medicine

Caroline M. Ledbetter, n/a – Sr Professional Research Assistant, University of Colorado, Denver

Jason Hoppe, DO – Associate Professor, University of Colorado, Denver

Kennon Heard, MD – Professor of Emergency Medicine, University of Colorado Denver-Emergency Medicine


Background and Objectives: Back pain is a frequently treated with opioids in the emergency department (ED). While opioids offer effective symptom control for acute pain, long-term use is associated with significant negative health effects. The objective of this study is to develop a risk-stratification tool based on variables readily available in the electronic health record (EHR) that be used to identify patients at risk for ongoing opioid use (OOU) following an ED visit for back pain.

Methods: A retrospective study of adult, opioid-naïve (ON) patients discharged from the ED with a diagnosis of back pain. Clinical variables were abstracted from the EHR and opioid prescription fills for the 6 months prior to and following index ED visit were determined from the state prescription drug monitoring program. Patients were considered ON if they had no opioid prescriptions in the 6 months preceding the ED visit and OOU was defined as >90 day supply of opioids filled in the 180 days following index ED visit. We used five algorithmic methods for prediction based on their ability to predict class probabilities well: - logistic regression, classification and regression trees (CART), boosted trees, random and multivariate adaptive regression splines (MARS). A non-informative model that uses no information from predictors was used for comparison (using AUC)

Results: Among 24,487 ON patients, the median (IQR) age was 38 (28-52) years, 55% were women and 56% were non-Hispanic White and 575(2.4%) had OOU. All models performed significantly better than chance. Logistic regression performed the best (AUC 0.70) however the sensitivity and specificity were only 64% and 62% respectively. Age, race/ethinicity, insurance type, pain score, administration of sedatives in the ED and opioid prescription at discharge were most associated with OOU.

Conclusion: While we were able to identify clinical characteristics associated with OOU, we could not develop a prediction tool with a high sensitivity and specificity. Limitations to this study include the use of only prescription opioids in our definition of OOU, the possibility of inaccuracy of the EHR for clinical variables and the lack of generalizability to other settings.



  Print Poster  View Poster
Poster Thumbnail
Noninvasive Hemodynamics of Acute Heart Failure in the Emergency Department Utilizing the ClearSight™ System

Sarah Meram, MS – Research Assistant, Wayne State University School of Medicine Department of EM Research

Xiangrui Li, MS

Christine Lee, PhD

Dongxiao Zhu, PhD

Peter Pang, MD, MS – Professor, Indiana University

Patrick Medado, n/a

Phillip Levy, MD, MPH – Assc Chair for Research, Department of Emergency Medicine and Asst VP for Translational Science and, Wayne State University

Sarah Meram, MS – Research Assistant, Wayne State University School of Medicine Department of EM Research


Background and Objectives: In depth characterization of the hemodynamic (HD) profiles of African American patients who present to the ED with acute heart failure (AHF) is not well known. We sought to identify HD characteristics of AHF patients with a goal of identifying therapeutic targets to improve clinical outcomes.

Methods: We used an on-going prospective, observational registry to identify patients who presented with signs and symptoms of AHF at two large, urban academic EDs: Wayne State University (Detroit, MI) and Indiana University (Indianapolis, IN). 350 patients were enrolled from July 2017 to March 2019. Continuous ED HD data was collected using the non-invasive ClearSight™ System. Mean values for HD variables were taken at four timepoints. Those with an ED diagnosis of AHF as adjudicated by site PIs and available ejection fraction (EF) were included. Clinical outcomes of 30-day readmission and mortality were recorded. Consensus clustering with K-means as the base algorithm was performed to help identify the groups with similar HD characteristics using 20 HD and demographic features. Cluster group comparisons were analyzed using a two-sample t-test.

Results: There were 164 adjudicated cases of AHF with prior EF and known clinical outcomes included. The population was predominately African American (92.5%) males (63.8%) with an average age of 58.9. There was no clear clustering effect found. However, within a mainly reduced EF (defined as < 40%) population (73.8%), two subgroups were identified. While both clusters had similar heart rates (cluster 1 85.2 bpm SD 13.3; cluster 2 87.9 bpm SD 12.6; p-value 0.36) statistically distinct HD characteristics were found. Cluster 1 (n=48) had normal SBP (99.2 SD 18.9/66.4 SD 13.1), decreased dPdT (379.1 SD 154.3), and a lower cardiac output [CO] (4.1 SD 1.5). Cluster 2 (n=32) had markedly higher SBP (167.1 SD 20.6/97.9 SD 11.5), increased dPdT (827.9 SD 288.2) and significantly elevated CO (5.8 SD 1.3). All p-values for SBP, dPdT and CO were <0.00001. Cluster 1 had a higher rate of 30-day readmissions (16.7%) than cluster 2 (9.4%).

Conclusion: Two diverse clusters were identified using non-invasive HD monitoring in the ED for AHF patients. More research is needed to demonstrate the effects of treatments specifically tailored to these HD characteristics that will lead to improved clinical outcomes for patients with AHF in the ED setting.



  Print Poster  View Poster
Poster Thumbnail
HEART-CT: A Novel Clinical Pathway to Increase Discharge Rates in Patients With Acute Chest Pain

Andrew Matuskowitz, MD – Assistant Professor, Medical University of South Carolina

Jihad Obeid, MD

Lindsey Jennings, MD, MPH – Assistant Professor, Medical University of South Carolina

Viswanathan Ramakrishnan, PhD

Andrew Matuskowitz, MD – Assistant Professor, Medical University of South Carolina


Background and Objectives: Over half of adults presenting to the emergency department (ED) with acute chest pain are admitted to the hospital for suspected acute coronary syndrome (ACS), though fewer than 10% are ultimately diagnosed with this disease. The HEART Pathway and coronary CT angiography are two risk stratifying tools that have separately demonstrated high negative predictive value in ruling out ACS in lower risk groups. Yet, no studies have tested whether integration of these tools could further reduce hospital admissions. We developed a Smart Form embedded in the electronic health record (EHR) that combines these tools – called HEART-CT – and provides management recommendations. The aims of this study are to test the safety of HEART-CT and compare clinical outcomes in HEART-CT adherent vs nonadherent groups.

Methods: This was a cohort study in a tertiary academic center. Patients ≥ 21 years old with a chief complaint of chest pain, a troponin result, and a completed HEART-CT Smart Form in the EHR were included. Patients with ED diagnosed ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) were excluded. Researchers blinded to adherence assessed outcomes by chart review. Outcomes included MACE within 30 days, ED disposition, ED length of stay (LOS), and provider adherence to HEART-CT. Categorical and numeric variables were compared using chi-squared and independent t-tests, respectively. Odds ratios were calculated by logistic regression.

Results: Of the 688 patients that met inclusion criteria, 16 were excluded for ED diagnosed STEMI or NSTEMI. Thus, 672 patients were included. 78.1% (525/672) were ED discharged. No patients identified as low risk (0/437) had MACE within 30 days (sensitivity 100%, p < 0.001). In patients with increased risk scores, ED discharge was 3.41 times more likely when providers were HEART-CT adherent than nonadherent (95% CI 2.20-5.27). There were no differences detected in MACE rates (OR 2.01, 95% CI 0.92-4.37) or ED LOS (-0.43 hours, 95% CI -0.92 to 0.83) when providers were adherent vs nonadherent, respectively.

Conclusion: HEART-CT identified 78.1% of chest pain patients as safe for discharge and demonstrated 100% sensitivity for 30-day MACE. Adherence to HEART-CT in patients with high risk scores resulted in increased ED discharge rates without increasing MACE or LOS compared to nonadherence.



  Print Poster  View Poster
Poster Thumbnail
Association Between Opioid Analgesia and Delays to Cardiac Catheterization of Patients With Occlusion Myocardial Infarction

Alexander Bracey, MD – Attending Physician, Stony Brook University

H Pendell Meyers, MD – Fellow, Stony Brook University

Daniel D. Singer, MD – Resident, SUNY at Stony Brook

Wei Li, MD – Resident, Stony Brook University

Steven Smith, MD – Professor, Hennepin County Medical Center

Adam Singer, MD – Professor and Vice Chairman for Research, Stony Brook University

Catherine Silberstein


Background and Objectives: Emergent cardiac catheterization (CC) for acute coronary syndrome (ACS) is recommended with ongoing ischemic symptoms regardless of ECG. Opioids are sometimes given for ACS, though evidence has shown an association between opioids and mortality. We hypothesized that opioids may mask ongoing symptoms of unrecognized coronary Occlusion MI (OMI) delaying emergent reperfusion. Our aim was to explore the association between opioid administration, delays to CC, and outcomes in ACS.

Methods: We conducted a retrospective, observational, case-control study of ED patients with suspected ACS who underwent CC at a large academic center during a 4 month period in 2018. Patients were grouped based on whether they received opioids prior to CC. The main outcomes were door-to-balloon times (DTBT) and peak troponins (T). Outcomes were compared between groups using parametric or non-parametric tests as necessary.

Results: 271 patients underwent CC. Mean age was 65, 31.7% were female, and 85.2% were white. Of those, 228 (84.1%) did not receive opioids prior to CC. The 43 (15.8%) patients that received opioids had a mean DTBT of 2,123 minutes compared to 1,643 minutes in those without opioids (P<0.001). Median peak T were 0.55 ng/mL vs. 1.35 ng/mL in patients without and with opioids respectively, P<0.001. Of the 228 without opioids, 45 (19.7%) were found to have STEMI(-) OMI, while 20 (46.5%) of the 43 that did receive opioids were found to have STEMI(-) OMI (P<0.001). 65 (23.9%) patients were found to have STEMI(-) OMI at the time of CC. The 45 patients with STEMI(-) OMI without opioids had a DTBT of 75 minutes, vs. 684 minutes for the 25 STEMI(-) OMI patients with opioids (P<0.001).

Conclusion: The administration of opioids prior to CC in patients with suspected ACS is associated with longer DDTB, and greater peak troponins. The rate of OMI was more than double in those without compared with those with pre CC opioids. This may help explain worse outcomes in those receiving opioids.



  Print Poster  View Poster
Poster Thumbnail
Does Inability to Lay Flat and Ambulate in the Emergency Department Predict Heart Failure and Admission?

Adam Singer, MD – Professor and Vice Chairman for Research, Stony Brook University

Henry Thode, Jr., PhD – Assistant Professor, Stony Brook University

Kyle S. Fortner, BS – Senior Manager, Clinical Trials, Abbott

Brian Bales, MD – Professor, Vanderbilt University

Chad Cannon, MD – Professor, University of Kansas Medical Center

Anna Marie Chang, MD – Professor, Thomas Jefferson University

George Glass, MD – Assistant Professor, University of Virginia

Eric Gross, MD – Professor, University of California, Davis

Sergey Motov, MD – Professor, Maimonides Medical Center

Daniel Spoon, MD – Professor, International Heart Institute of Montana

Frank Peacock, MD – Professor, Baylor College of Medicine

Catherine Silberstein


Background and Objectives: Diagnosis and risk stratification of patients with suspected acute heart failure (AHF) is problematic; most patients directly admitted to the hospital. We determined whether inability to ambulate and lay flat predicted AHF and admission.

Methods: We conducted a prospective, multicenter study of adult ED patients with suspected AHF between 2014-2015. Data were collected and the ability to lay flat and ambulate while in the ED was determined. Outcomes were an adjudicated diagnosis of AHF and disposition. We determined the association of inability to lay flat and ambulate in the ED with adjudicated AHF, admission, and ICU admission using univariate and multivariate analyses using stepwise logistic regression.

Results: There were 330 patients. Mean age was 63 (14), 63% were male, 72% were white. New or worsening adjudicated AHF was diagnosed in 129 (39%) patients. Of all patients, 53% were able to lay flat and 83% could briefly ambulate in the ED. 240 patients (73%) were admitted (6% to an ICU). Median (IQR) ED LOS was 7.5 (5.4-11.5) hours; median (IQR) hospital LOS was 78 (43.6-141.7) hours. Other comorbidities requiring admission were present in 184 patients (56%). Inpatient mortality was 4%. Compared with patients without AHF, patients with AHF were older (65 vs. 61, P=0.03), more likely male (71% vs. 58%, P=0.03), and less likely to lay flat (41% vs. 61%, P=0.001). Multivariate (odds ratio; 95%CI) predictors of AHF included edema (2.24; 1.13-4.46), orthopnea (2.45; 1.23-4.88), weight gain (7.11; 2.47-20.46), sputum production (0.26; 0.11-0.64), CXR abnormalities (3.40, 1.50-7.73),and elevated BNP/NT-pro BNP (12.50; 6.26-24.99). Admitted patients were older than non-admitted (64 vs. 59, P=0.006), and less likely to lay flat (50% vs. 64%, P=0.03). Multivariate predictors of admission included heart rate (1.02/bpm; 1.00-1.04), edema (2.35; 1.11-4.97), confusion (0.06; 0.004-0.91), elevated BNP/NT-pro-BNP (4.72; 2.03-10.95), and co-morbidities (24.81, 9.80-62.84). Multivariate predictors of ICU admission included respiratory rate (1.09/RPM; 1.03-1.17); renal disease (4.03; 1.10-14.80), and inability to ambulate in the ED (2.67; 1.03-6.90).

Conclusion: In ED patients with suspected AHF, inability to lay flat while in the ED is predictive of ICU admission, but not associated with AHF diagnosis or admission after controlling for confounding variables.



  Print Poster  View Poster
Poster Thumbnail
The Association of Cannabis Use and Cardiac Dysrhythmia: A Systematic Review

John Richards, MD – Professor, University of California, Davis, School of Medicine

Eike Blohm, MD – Assistant Professor, University of Vermont Medical Center

Kara Toles, MD – Assistant Professor, UC Davis Emergency Department

Angela Jarman, MD, MPH – Assistant Professor, University of California, Davis Medical Center

Dylan Ely, MD – Resident Physician, University of California, Davis Medical Center

Joshua Elder, MD, MPH, MHS – Assistant Professor, University of California, Davis Medical Center

John Richards, MD – Professor, University of California, Davis, School of Medicine


Background and Objectives: Cannabis use results in elevation of heart rate and blood pressure immediately after use, due to sympathetic nervous system stimulation and parasympathetic nervous system inhibition. These effects may precipitate cardiac dysrhythmia. The objective of our study was to analyze systematically the pertinent medical literature regarding the association between cannabis use and cardiac dysrhythmia.

Methods: We queried PubMed, Google Scholar, and OpenGrey, and reviewed results for relevance. We graded clinical trials, observational and retrospective studies, case series and reports using Oxford Centre for Evidence-Based Medicine guidelines.

Results: There were 3 Level I systematic reviews of 36 articles, 16 Level II studies with 6,942 subjects, and 9 Level III studies with 3,797,096 subjects. Cannabis-induced tachycardia was highlighted in 17 of 28 (61%) Level I - III studies followed by the generalized description of dysrhythmia in 8 (29%). Specific dysrhythmias mentioned include atrial fibrillation, atrial flutter, atrioventricular block, premature ventricular contractions, premature atrial contractions, ventricular tachycardia, and ventricular fibrillation. Other reported findings on electrocardiogram included ST segment elevation, P and T wave changes. Only one Level III study reported a decreased risk of atrial fibrillation from cannabis use (Odds ratio = 0.87). There were 39 case series (Level IV) and case reports (Level V) with 42 subjects. Average age was 30 ± 12 years, and only 10 (24%) were female. The most common dysrhythmia was ventricular fibrillation (21%), followed by atrial fibrillation (19%), ventricular tachycardia (12%), third degree atrioventricular block (12%), and asystole (12%). There were 4 cases (10%) of symptomatic bradycardia. Notable ECG changes included ST segment elevation (29%), Brugada pattern in leads V1, V2 (14%), and right bundle branch block (12%). There were 8 cases of cardiac arrest, of whom 5 expired.

Conclusion: Cannabis use is associated with increased risk of cardiac dysrhythmia, which may be life-threatening. Clinicians and nurses should inquire about acute and chronic cannabis use by their patients presenting with tachycardia, bradycardia, dysrhythmia, chest pain, and/or unexplained syncope. Patients of all ages who are chronic or occasional users of recreational or medical cannabis should be educated on this deleterious association.



  Print Poster  View Poster
Poster Thumbnail
Heat Index Greater Than 100 degrees Fahrenheit Increases the Incidence of Myocardial Infarction

Wendy Huang, MD – Resident Physician, Washington University in St. Louis

Jason A. Horowitz, n/a – Medical Student, Wayne State University

Caitlin Wellborn, MD – Resident Physician, Washington University in St. Louis

Kristen Mueller, MD – Assistant Professor, Washington University in St. Louis

Laura Wallace, MD, n/a – Instructor, Washington University in St. Louis

Wendy Huang, MD – Resident Physician, Washington University in St. Louis


Background and Objectives: Every year, 735,000 Americans experience a myocardial infarction (MI) and 370,000 die. Exposure to extreme weather, such as a heat index greater than 100 degrees Fahrenheit, may be a modifiable risk factor for MI. If it is, improving access to shelter and air conditioning, especially amongst the homeless and impoverished, could save lives. Therefore, the purpose of this study is to test the hypothesis that the incidence of MI is increased on days when the heat index is greater than 100 degrees Fahrenheit compared to days when the heat index is lower.

Methods: A cross-sectional study was undertaken via retrospective chart review. All patient records with a diagnosis of ST-segment elevation MI or non-ST-segment elevation MI who presented to the emergency department at Barnes Jewish Hospital in Saint Louis during the two-year period between January 1, 2016 and December 31, 2017 were identified. The patient data was then paired with weather data from the National Weather Service based on the date of presentation to the emergency department. The paired data was then analyzed via chi-squared test to determine if the incidence of MI on days when the heat index was greater than 100 degrees Fahrenheit was significantly different from the incidence of MI on days when the heat index was lower.

Results: During the 731-day study period, 1,239 patients were diagnosed with a MI. During the same period, the heat index exceeded 100 degrees Fahrenheit 231 out of 731 days. Of the 1,239 MIs observed, 439 presented to the emergency department on days when the heat index exceeded 100 degrees Fahrenheit for an average of 1.90 MIs per day. The remaining 800 MIs presented on the 500 days with a lower heat index for an average of 1.60 MIs per day. The observed increase in the incidence of MI on days when the heat index exceeded 100 degrees Fahrenheit was statistically significant upon chi-squared analysis (p<0.05).

Conclusion: The incidence of MI is increased on days when the heat index is greater than 100 degrees Fahrenheit compared to days when the heat index is lower. In a city, such as Saint Louis, where the homeless rate is 2% and the poverty rate is over 30%, improving access to shelter and air conditioning on hot days may potentially save lives. However, due to demographic and lifestyle variations from city to city, further study is needed to determine if this result is generalizable to other populations.



  Print Poster  View Poster
Poster Thumbnail
Pilot Study: Impact of a Weighted Vest on Cardiopulmonary Resuscitation by Low Body Weight Individuals

Terri Davis, MD – University of Florida College of Medicine

Thomas Marshall, MD – Assistant Professor and Vice Chairman for Community Operations, West Virginia University

Rosemarie Fernandez, MD – Associate Professor, University of Florida

Terri Davis, MD – University of Florida College of Medicine


Background and Objectives: Individuals weighing less than 140-pounds perform compressions to a significantly lower depth than heavier rescuers during cardiopulmonary resuscitation (CPR). The aim of the present study was to determine if artificially increasing rescuer weight would increase the depth of compressions during CPR to increase the percent of people meeting American Heart Association (AHA) guidelines for effective CPR.

Methods: We performed a randomized controlled trial assessing the ability of 42 medical and nursing students weighing less than 140 lb to perform 2 minutes of CPR. Subjects performed 2 minutes of CPR on a Laerdal SimMan 3G mannequin. The mannequin was on a backboard on a stretcher 21 inches above the floor. All participants used a 10-inch stepstool. There were 21 subjects in the control group and 25 in the intervention group. The mean weight of the control subjects was 122.7 lb. The mean weight of the intervention group was 125.2 lb. Subjects in the intervention group were given weight vest of 15, 20, or 25 lb to increase their total weight to at least 150 lb. The primary outcome was compression depth complying with AHA standards, which is a CPR compression depth of 50 mm. A secondary outcome was any increase in compression depth, because studies have shown an increase in compression depth increases the success of defibrillation and survival.

Results: Forty-six CPR cycles were recorded. Forty-five of the cycles were performed by females, and 1 performed by a male. Only four individuals reached the goal depth of 50 mm, and all were in the intervention group. In this study, 0% of the control group and 16% of the intervention group met AHA compression guidelines. The mean depth for the control group was 39 mm and in the intervention group was 39 mm, showing no benefit in wearing the weighted vest during CPR.

Conclusion: This pilot study provided no evidence that wearing a weight vest improves the depth of compression during CPR.



  Print Poster  View Poster
Poster Thumbnail
Compliance With the American College of Emergency Physicians

Sameer Desai, MD – Associate Professor, University of Kentucky College of Medicine

David Pottinger – Medical Student, University of Kentucky College of Medicine

David Pottinger – Medical Student, University of Kentucky College of Medicine


Background and Objectives: In 2013-2014, ACEP released a set of 10 recommendations for EM providers as part of the Choosing Wisely guidelines, a campaign designed to reduce unnecessary tests and procedures. One recommendation involved the use of CTs for patients with flank pain and a previous diagnosis of nephrolithiasis. Because many patients repeatedly develop kidney stones, a CT scan on each ER presentation for flank pain can result in excessive radiation exposure. Moreover, these CTs rarely lead to changes in treatment. Therefore, they recommended that providers avoid ordering CTs in patients with uncomplicated renal colic and a previous diagnosis of kidney stones. The goal of this study was to assess how frequently EM providers at a major academic hospital complied with ACEP guidelines for the usage of CT stone protocols in uncomplicated renal colic.

Methods: This is a chart review study. The population consisted of 150 adult patients with the primary complaint of renal colic and a previous diagnosis of nephrolithiasis, who presented to the UK Albert Chandler ED between 2014 and 2019. By reviewing their ED notes, a retroactive determination was made as to whether a renal CT was indicated, based on ACEP guidelines. We then reviewed whether the EM provider ordered a CT or not. Each case was then placed into 1 of 4 groups: CT indicated and administered, CT indicated but not administered, CT not indicated but administered, and CT not indicated and not administered. The percent compliance of both administering and not administering CT scans was calculated.

Results: We found 59 guideline-compliant renal CT orders, 45 non-guideline compliant CT orders, 30 instances where attendings correctly did not order CTs (per guidelines), and 16 instances where a CT scan was indicated under ACEP guidelines, but not given. Therefore, we found that when the guidelines called for a renal CT, it was given 79% of the time. When the guidelines did not recommend a CT, it was withheld only 40% of the time. Of note, however, is that in the “CT indicated but not given” group, many providers mentioned high cumulative radiation exposure, so we felt these decisions were often defendable.

Conclusion: Our analysis indicated that renal CTs were frequently being given when guidelines suggest they were unnecessary. Pending additional investigation, there may be room for further education of ER providers on this subject.



  Print Poster  View Poster
Poster Thumbnail
Compliance With the American College of Emergency Physicians

Sameer Desai, MD – Associate Professor, University of Kentucky College of Medicine

David Pottinger – Medical Student, University of Kentucky College of Medicine

David Pottinger – Medical Student, University of Kentucky College of Medicine


Background and Objectives: Background: In 2013-2014, ACEP released a set of 10 recommendations for EM providers as part of the Choosing Wisely guidelines, a campaign designed to reduce unnecessary tests and procedures. One of these recommendations related to the management of syncope. Most syncopal episodes are driven by benign causes. For this reason, head CTs are relatively unlikely to be helpful, so ACEP suggested that they should only routinely be ordered if there are signs of stroke or head trauma. Failure to follow these guidelines would have significant negative effects, as it would unnecessarily increase the costs of healthcare and expose the patient to radiation. Objective: The purpose of this study was to assess how frequently EM providers at a major academic hospital complied with ACEP guidelines for the usage of head CTs in evaluating syncope.

Methods: This is a chart review study. The population consisted of 150 adult patients with the primary complaint of syncope, who presented to the UK Albert Chandler ED between 2014 and 2019. By reviewing the patients’ ED notes, a retroactive determination was made as to whether a head CT was indicated, based on ACEP guidelines. We then reviewed whether the EM provider in each case ordered a head CT or not. This allowed placement of each case into 1 of 4 groups: CT indicated and administered, CT indicated but not administered, CT not indicated but administered, and CT not indicated and not administered. The percent compliance of both administering and not administering CT scans was then calculated. A set of qualitative details about each patient was also recorded.

Results: In total, we found 28 guideline-compliant head CT orders, 5 non-guideline compliant CT orders, 111 instances in which providers correctly did not order CTs (according to guidelines), and 6 instances in which the guidelines suggested a CT scan, but one was not given. Using these results, we calculated that when the guidelines called for a head CT, it was given 82% of the time. When the guidelines did not call for a CT, it was withheld 96% of the time.

Conclusion: Our sample suggests that ACEP guidelines are being followed to a high extent in the UK Albert Chandler ED. This may indicate that education of EM providers on this subject has been successful. However, generalizability of this study may be limited, given that it was conducted at a major academic center.



  Print Poster  View Poster
Poster Thumbnail
Prolonged Hospital Stay for Low-Risk Acute Heart Failure Patients

Christian Klaucke, MD – Assistant Professor of Emergency Medicine, University of Massachusetts Medical School

Chad Darling, MD – Associate Professor of Emergency Medicine, University of Massachusetts

Christian Klaucke, MD – Assistant Professor of Emergency Medicine, University of Massachusetts Medical School


Background and Objectives: Previous studies have stratified a low risk acute heart failure (AHF) population appropriate for observation unit (OU) care based on data available at time of ED presentation. However, further prediction of and preparation for low risk patients’ clinical course variations is needed, especially for those arriving at hospitals without dedicated OUs and who go on to have prolonged inpatient length of stays (LOS) beyond the US median 3.4 days (81.6 hours). The purpose of this study is to identify medical and social variables adversely correlated with early discharge in order to further stratify low risk AHF patients and for designing robust post-discharge support structures.

Methods: We reviewed ED and inpatient charts of patients 65 years and older previously enrolled in a prospective AHF study at an academic medical center between 2011 and 2014 prior to the implementation of an OU. We identified a low risk cohort based on Society of Chest Pain Centers recommendations, describe this group’s incidence among all AHF ward admissions, and create a case series exploring themes in prolonged admitted LOS beyond the national AHF median.

Results: Of 178 patient visits initially admitted to a ward unit with an ED diagnosis of AHF, 66 (38.2%) were low risk. The median age was 80 years. Median ED LOS was 7.6 hours and inpatient LOS was 67.9 hours (IQR: 35.4, 94.8). Three patients (4.4%) later went to a step down or intensive care unit, all for non-AHF complications. Two patients died within 30 days of discharge from non-cardiac causes. Twenty-three (34.8%) patient visits had admitted LOS > 81.6 hours. In univariate analysis, patients with a long admitted LOS were more likely to get echocardiograms, have ED troponin I values between 0.05 and 0.12, as well as be discharged to rehabilitation or skilled nursing. More than 70% of our low risk cohort was admitted on supplemental oxygen and this was not correlated with prolonged LOS.

Conclusion: Published recommendations identifying low risk AHF patients may not adequately predict their inpatient LOS at institutions without OUs, although they may identify patients at low risk for serious short term cardiac complications. Further stratifying this acute low risk population at ED presentation in terms of their clinical recovery needs may be helpful in determining when ongoing recuperation can be safely transitioned to a non-inpatient setting.



  Print Poster  View Poster
Poster Thumbnail
A Multicenter Analysis of an Emergency Physician Lead on Department Flow and the Provider Experience

Kathryn Crowder, MD, BSc, BN, CCFP-EM – Assistant Professor, University of Calgary

Elizabeth Domm, RN BScN MSN PhD – Associate Professor, University of Regina

Rachel Lipp, n/a

Owen Robinson, n/a

Shabnam Vatanpour, n/a

Dongmei Wang, n/a

Eddy Lang, n/a

Kathryn Crowder, MD, BSc, BN, CCFP-EM – Assistant Professor, University of Calgary


Background and Objectives: Emergency department (ED) flow is a predictor of patient safety, quality of care and provider satisfaction. Throughput interventions have been shown to improve flow, yet few studies have considered MD leadership roles and evaluated provider experience. Our objective was to evaluate the emergency physician lead (EPL) role, a novel MD staffing initiative.

Methods: This mixed-method observational time series analysis evaluated ED metrics at two tertiary EDs including ED length of stay (LOS), EMS Park LOS and physician initial assessment (PIA) time as well as 72-hour readmit and left without being seen (LWBS) rates. Data was collected from the ED information system database for control (Dec 6, 2017-Feb 28, 2018 SITE1 and Mar 1–May 31, 2018 SITE2), pre (Sept 3-Nov 30, 2018 SITE 1 and Dec 3, 2018-Feb 28, 2019 SITE2) and post (Dec 3, 2018 –Feb 28, 2019 SITE1, Mar 1- May 31, 2019 SITE2) periods for adult patients presenting to each site. Site data was analyzed independently using descriptive and inferential statistics to calculate differences in means, which compared using t-tests. A survey elicited provider feedback from ED physicians, nurses, and EMS professionals on the effect of the EPL on throughput, timeliness of dispositions, provider workload, and the EPL as a resource to other professionals.

Results: The number of ED visits at SITE1 were 13136 (Ctrl), 13236 (Pre) and 13137 (Post), and at SITE2 were 14371(Ctrl), 13866 (Pre) and 14962 (Post). Mean ED LOS was decreased by 17 min in post vs control and 20 min vs pre at SITE1 (p<0.01). SITE2 saw an increase in ED LOS by 7 min vs control and 8 min vs pre (p<0.01). EMS LOS at SITE1 was decreased by 21 min vs control and 22 min vs pre (p<0.01), but was increased at SITE2 by 2 min vs control (p=0.09) and 14 min vs pre (p<0.01). PIA time at SITE1 was decreased by 15 min vs control (p<0.01) and 13 min vs pre and increased by 5 min vs control and 12 min vs pre at SITE2 (p<0.01). 72 hour readmit and LWBS rates were unchanged at both sites. Qualitative feedback from ED providers highlighted the early provision of treatments and investigations by the EPL, and many felt the EPL was an important resource.

Conclusion: The inclusion of both quantitative and qualitative data in this study provided a robust analysis of the impact of the EPL role and demonstrated modest but important improvements. A site-dependent, carefully considered implementation of the EPL role may improve ED metrics and provider experiences.



  Print Poster  View Poster
Poster Thumbnail
Effect of Patient Volumes and Holds on Patients Leaving Without Being Seen

Noah Halpern

James Ziadeh, n/a

Jeff Ditkoff, n/a

Jose Rivera, n/a

Robert Swor – Emergency Department Director of Research, Oakland University William Beaumont School of Medicine

Robert Swor – Emergency Department Director of Research, Oakland University William Beaumont School of Medicine


Background and Objectives: Patients leaving emergency departments prior to being seen by a provider (LWBS) is a prevalent issue in the United States. Although research has been undertaken to assess patient characteristics that lead to leaving without being seen by a provider, as well as initiatives and interventions to curb this patient practice, less research has been conducted into how volumes of incoming or boarded ED patients affect LWBS rates. For these reasons, our objective is to assess whether emergency department patient volume or ED boarding are associated with number of patients LWBS.

Methods: We performed a retrospective analysis of emergency department census data from a single large academic community hospital from January 2018- October 2019. We captured data on monthly LWBS volumes (defined as those patients registered in the department who left prior to being evaluated by a physician/advanced practice provider) as well as monthly ED volume (total number of patients registered in the ED) and ED hold hours. Total ED Hold hours were defined as the total number of hours each month that patients were boarding in the ED (measured as time beginning 102 minutes after order to admit placed until moved from the department). Monthly proportions of LWBS as a function of ED volume and total hold hours were calculated. To assess the relationship of ED volume and hold hours to LWBS we calculated Pearson correlation coefficients.

Results: During the study period, monthly patient census was as follows: ED volumes (mean =10636, range 9581-11437), monthly hold hours (mean= 7106 range 4134-13646), and monthly number of LWBS patients (mean=181, range 54-430). Proportions of patients LWBS varied from 0.5%-4.0% of ED volume and 0.5%-4.1% of ED hold hours. Number of LWBS patients was minimally correlated with ED volume (pearson=0.19) but highly correlated with ED hold hours (pearson=0.77).

Conclusion: This data shows that the number of patients leaving the ED without being evaluated by a provider is more strongly associated with boarding/hold times, rather than ED volume. Initiatives in the back end of hospital flow to reduce ED hold times may positively impact LWBS rates



  Print Poster  View Poster
Poster Thumbnail
Emergency Department Observation Services: An Evaluation of Two Models of Care

Sanjey Gupta, MD – Associate Professor, Zucker School of Medicine at Hofstra/Northwell

Jason Brenner – Academic Associate, Southside Hospital, Northwell Health

William Apterbach – Northwell Health

Gregory Garra – Assoc Chair, Emeregency Medicine, Northwell Health/Zucker School of Medicine

Sanjey Gupta, MD – Associate Professor, Zucker School of Medicine at Hofstra/Northwell


Background and Objectives: As hospital utilization is shifting, the space, staffing needs, and physical location of observation services (obs) are gaining increasing importance in the management of short stay patients. Our academic ED transitioned from an attending led, in-situ ED, scatter bed model to a dedicated team- based obs unit (CDU) with an ACP/nursing team. The objectives of this study are to evaluate changes in associated metrics, including volume, obs indication, case distribution, ED LOS and admission rate impact.

Methods: This uncontrolled before-after study was performed in a 78K visit urban academic ED with a 19% admission rate. The subjects include all patients with designated “observation” status in the 6 months pre &post CDU opening. Prior to CDU opening, obs patients were held in ED scatter beds run by ED attendings/nurses. After opening, the physical CDU held 6 patients with a dedicated ACP/nurse team with a supervisory physician adjacent to the ED. Analyzed data included descriptive statistics, volume, LOS, obs indications, cases types, admission rates, treat and release times (T&R). Analysis was performed with the T-test, Chi-squared, Fisher Exact test, significance p<0.05.

Results: There were 522 vs 1734 obs cases, or 2.9 vs 9.6 cases/day, pre/post CDU opening. Gender distribution pre/post CDU was M 51.53% F 48.47% vs M 57.55 F 42.45%. The CDU LOS (in minutes) pre/post CDU was 1390 SD 908 vs 1433 SD 903. The pre/post LOS stratification was admit 1439 vs 1481, discharge 1372 vs 1438, and AMA 1410 vs 1017, p<0.018. The pre/post CDU disposition breakdown was admit 23.56% vs 23.24%, discharge 70.50% vs 72.72%, AMA 5.94% vs 4.04%, p=0.01. The pre/post changes in the case distribution by clinical diagnosis for obs and the indication for obs (diagnostic uncertainty vs therapeutic intensity) did not achieve significance. The hospital admission rate from the ED pre/post CDU was 19.6% vs 19%, p< 0.043. The ED T&R LOS pre/post CDU was 239 vs 235, with a 3.9% rise in ED volume.

Conclusion: A dedicated CDU with clinical team will lead to a rise in obs utilization, but may not result in positive changes to obs or other ED metrics. Patient disposition from a CDU may be more favorable with a reduction in AMAs.



  Print Poster  View Poster
Poster Thumbnail
Comparing Video and Audio Interpretation Services in the Modern Emergency Health Care Setting

Emily Au, n/a

Michael Chary – PGY-3, Boston Children's Hospital

Sara Verma

Nameka Khan

Jonathan Siegal, MD – Vice Chairman Emergency Medicine, NYP Queens

Jonathan Siegal, n/a – Vice Chairman Emergency Medicine, New York–Presbyterian Queens

Jonathan Siegal, MD – Vice Chairman Emergency Medicine, NYP Queens


Background and Objectives: Ad hoc interpreters (family/staff) are more likely than certified interpreters to inaccurately translate medical information. Medical screening exams (MSE) in the ED should be conducted in a patient’s preferred language with translation by a certified medical interpreter. Approximately 1 in 5 US citizens prefers to communicate in a language other than English or has limited proficiency in English predominantly living in urban areas. ED in urban areas must rapidly screen high volumes of patients for life-threatening injuries. There exists a need to identify the most efficient means of providing interpretation during MSE. Our hypothesis is that audiovisual interpretation (AVI) is faster than audio interpretation (AI) because AVI contains informative nonverbal cues.

Methods: We conducted a prospective single-center survey, block randomization advanced practice providers (APP) to use audio or audiovisual interpretation when providing a MSE while awaiting triage. We enrolled all patients 22 years or older at the time of presentation who preferred to communicate in a language other than English. We excluded any patient that had immediately life-threatening injuries, hearing impairment, unable to provide consent, declined to participate or asked for a family member to interpret instead. Our primary outcome measure was the duration of interpretation. We used a two-way ANOVA to determine the significance of the difference in interpretation between modalities and the influence of language on this difference.

Results: We enrolled 129 participants (audiovisual = 57, audio = 72) between January and March 2019. Patient demographics include gender (male = 45, female = 84), age (46 ± 13 years), and language used for interpretation (Spanish = 104, Mandarin = 18, Korean = 4, Bengali = 2, Arabic = 1). Only patients using Spanish or Mandarin interpretation were included in subsequent analysis. The interview length was 600 +/- 150 seconds. AVI was significantly faster than AI (481 seconds vs. 705 seconds via two-way ANOVA, p= 0.000192). Age, gender, and preferred language were not significantly different between the two groups.

Conclusion: When providing Spanish or Mandarin translation, AVI is significantly faster than AI. Limitations of this study include the lack of pediatric patients, low enrollment, and a ceiling effect on the questionnaire. Next step is a larger study to gather data for more languages.



  Print Poster  View Poster
Poster Thumbnail
Quick Look Process In the Emergency Department

Frederick Davis, DO, MPH – Associate Chair, Northwell Health, Long Island Jewish Medical Center

Nancy Kwon, MD, MPA – Vice Chair, Emergency Medicine, Long Island Jewish Hospital, Long Island Jewish Medical Center

Adam Berman, MD, MS – Associate Chair, Northwell Health, Long Island Jewish Medical Center

Irina Khailov, PA – ACP Supervisor, Northwell Health, Long Island Jewish Medical Center

Diana Fuzailov, PA – Senior ACP, Northwell Health, Long Island Jewish Medical Center

Elizabeth McEntee, RN – Nurse Manager, Northwell Health, Long Island Jewish Medical Center

Helena Willis, RN – Senior Administrative Director, Northwell Health, Long Island Jewish Medical Center

Sarah Jacobs – Academic Associate, Northwell Health, Long Island Jewish Medical Center

Frederick Davis, DO, MPH – Associate Chair, Northwell Health, Long Island Jewish Medical Center


Background and Objectives: As high volumes lead to longer lengths of stay in busy Emergency Departments, there have come about a number of ways to implement processes to help improve the flow and management of patients. We implemented a Quick Look process with a provider seeing lower acuity patients early on in their stay to start the work up earlier. The objective of this process was to allow for an earlier Door to Provider time with the intent to start the evaluation and work up earlier and lead to decreased Length of Stays.

Methods: The setting is an academic, urban, adult emergency department that sees over 100,000 patients annually. Once a patient was triaged to a level that would normally be seen in our split-flow Intake area, the provider scheduled for Quick Look, a combination of a physician and physician assistant, with the help of a scribe for documentation, would quickly evaluate the patient and place initial orders. The patient would then be handed off to another provider, a physician and resident team, or physician assistant, for completion of their work up.

Results: On days that this process was implemented, we saw an average decrease in both the Door to Provider and Length of Stay. The Door to Provider went from a mean of 70 minutes on average, on days this process was not implemented, to 45 minutes, on days this process was implemented, a reduction of 25 minutes (35% reduction), which was statistically significant with a p < 0.05 using the one sample t test. The Length of Stay went from 282 minutes on average, on days this process was not implemented, to 242 minutes, on days this process was implemented, a reduction of 40 minutes (14% reduction), which was statistically significant with a p < 0.05 using the one sample t test.

Conclusion: Despite increasing patient volume, the Quick Look Evaluation process that was implemented helped to reduce the Door to Provider time and ultimately the Length of Stay for patients, which helps increase efficiency to provide more timely care for the population seen.



  Print Poster  View Poster
Poster Thumbnail
Provider-in-Triage Prediction of Hospital Admission After Brief Patient Interaction

Michael Zwank, MD – Associate Professor, Regions Hospital

Nell R. Adams, n/a

Michael Zwank, MD – Associate Professor, Regions Hospital


Background and Objectives: We sought to determine if emergency physician providers working in the triage area (PIT) of the ED could accurately predict the likelihood of admission for patients at the time of triage. Such predictions, if accurate, could decrease the time spent in the ED for patients who ultimately are admitted to the hospital by hastening downstream workflow.

Methods: This is a prospective cohort study of PIT providers at a large urban hospital. Physicians were asked to predict the likelihood of admission and confidence of prediction for patients after evaluating them in triage. This included at the discretion of the provider: possible chart review, brief interview and brief physical exam. Physicians also predicted the service to which the patients would be admitted. Measures of predictive accuracy were calculated, including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

Results: 33 physicians (16 attendings, 17 residents) evaluated 300 patients and made predictions. The average patient age was 48 (range 18-94) and 55% were female. 70 (23.33%) patients were admitted (4.48% observation, 85.07% general care/telemetry, 7.46% progressive care, 2.99% ICU). Of these, 82.09% were admitted to general medicine and 14.93% were admitted to general surgery. Overall, physicians predicted 91 patients would be admitted of which 52 actually were. The sensitivity of determining admission for the entire cohort was 74.29%. The specificity was 83.11%. The PPV was 57.78% and the NPV was 92.57%. When correctly predicting admission, physician accuracy of predicting the admitting service was 86.54% (Kappa=0.56; 95%CI 0.29-0.83). When physicians were at least 80% confident in their predictions, the predictions improved: Sensitivity 96.2%, Specificity 93.6%, PPV 75.8%, NPV 99.2%.

Conclusion: The accuracy of physician providers-in-triage of predicting discharge was better than the accuracy of predicting admission. Those predictions made with confidence >80% were dramatically more accurate. Physicians predicted with reasonable accuracy the service to which patients were ultimately admitted. These results indicate that while general predictions of admission are likely inadequate to guide downstream workflow, predictions in which the physician is confident could provide utility.



  Print Poster  View Poster
Poster Thumbnail
Physical Therapy Reduces Emergency Department Resource Utilization and Return Visits in Atraumatic Low Back Pain

Andrew Pugh, MBBS – University of Utah School of Medicine

Kaytelin Suslavic, MD

Keith Roper, PT, DPT

Jake Magel, PhD, MSPT, DSc

Julie Fritz, PhD, PT, ATC

Troy Madsen, MD – Assistant Professor, University of Utah

Andrew Pugh, MBBS – University of Utah School of Medicine


Background and Objectives: Emergency department (ED)-initiated physical therapy (PT) is an emerging resource nationwide. Early data suggest that PT in the ED has a positive effect on a number of clinical and operational outcomes and may reduce downstream healthcare utilization. This study assesses the impact of ED-initiated PT on ED resource utilization and return rates in patients with atraumatic low back pain, the most common musculoskeletal complaint seen in US EDs.

Methods: We prospectively identified patients presenting with atraumatic low back pain to the University of Utah ED between January 2017 and June 2018. We collected baseline demographic information and recorded outcomes related to the ED stay and return visits up to one year after the index visit. We used a matched comparison design with age and gender to compare those who were evaluated by PT during the ED visit to those who did not have a PT assessment or treatment.

Results: Over the 18-month study period, we identified 112 patients with atraumatic low back pain for matched comparison (PT 56 vs. non-PT 56). Average age in each group was 42 years (range PT 18-82 vs. non-PT 18-81) and 50% of each group was female. Average ED length of stay was similar between groups (PT 3.7 hours vs. non-PT 4.6 hours, p=0.21). PT patients received fewer total imaging studies (PT 25% vs. non-PT 57%, p=0.029) and fewer advanced imaging studies with CT or MRI during the ED visit (PT 10.7% vs. non-PT 28.6%, p=0.017). Fewer PT patients returned to the ED at the one-year mark following the index visit: three days (0 vs. 5.4%, p=0.118), 30 days (5.4% vs. 12.5%, p=0.147) and one year (19.6% vs. 39.3%, p=0.003).

Conclusion: Patients with low back pain who received ED PT were less likely to have imaging studies in the ED and had lower ED return rates within the year following the initial ED visit. ED PT may not only offer therapeutic benefits to ED patients but may also positively impact ED resource utilization while not increasing ED length of stay.



  Print Poster  View Poster
Poster Thumbnail
Shift Duration and Wellness: A Survey of Advanced Practice Providers in the Emergency Department

Michael Zdradzinski, MD – Medical Education Fellow, Emory University School of Medicine

Tim Moran, PhD – Emory University School of Medicine

Jeffrey Lance, n/a

Ebony Blackmon, n/a

Michelle Lall, MD, MHS, FACEP – Assistant Professor, Assistant Residency Director, Emory University

Michael Zdradzinski, MD – Medical Education Fellow, Emory University School of Medicine


Background and Objectives: Health care worker burnout is a topic of major focus in emergency medicine. A recent study reported that Emergency Department Advanced Practice Providers (ED-APPs) have higher rates of burnout compared to a normative sample of healthcare workers. However, the impact of shift length on the wellness of ED-APPs has not been studied.

Methods: The APP group of a large, urban, safety-net emergency department in the United States recently changed their shift template from thirteen 12-hour shifts (156 hours) to fourteen 10-hour shifts (140 hours) per month. Approximate shift distribution is: 10 daytime, 1 evening, 0 night and 3 weekend, which did not significantly change. To study the change’s impact on burnout, the APP group was sent anonymous, voluntary surveys 3 months following the shift length change. Results were compared to baseline survey data obtained in 2016-2017 from the same group. The survey included the Maslach Burnout Inventory (MBI), a validated instrument that assesses three domains of burnout: emotional exhaustion, depersonalization, and personal accomplishment. The association between the change in shift duration and self-reported burnout was evaluated using mixed-effects/multilevel Bayesian regressions. Each subscale of the MBI was evaluated separately. Analyses were conducted using R v. 3.5.2 and MCMCglmm.

Results: 33 of 37 APPs were included in the study. 85% identified as female. 67% identified as White and and 30% identified as Black. The median age was 39 (IQR: 35 - 44). Prior to the change in shift schedules, the means and standard deviations for the emotional exhaustion, depersonalization, and personal accomplishment scales were 16.9 (4.4), 7.6 (2.3), and 39.2 (2.3), respectively. Following the change in schedules, the means and standard deviations for three scales were 19.4 (10.3), 8.6 (5.6), and 39.7 (3.7), respectively. The 95% credible intervals from the Bayesian regression overlapped 0 for emotional exhaustion (B = 2.5, 95% CI: -3.0 - 8.0), depersonalization (B = 1.0, 95% CI: -1.8 - 4.1), and personal accomplishment (B = 0.5, 95% CI: -1.7 - 2.5). These findings do not indicate that the change in shift schedules successfully alleviated burnout.

Conclusion: Reducing ED-APP shift length from 12 to 10 hours was not associated with a decrease in reported burnout. Further studies are needed to determine the effect of scheduling on ED-APP wellness.



  Print Poster  View Poster
Close this panel
Browse By Poster Author
Browse By Title
Close this panel
Stuff for Poster Tools
Stuff for Share

Help

Technical Support

(877) 426-6323

support@eventScribe.com

Feedback

SUBMIT FEEDBACKfeedback icon

We really appreciate your feedback on the eventScribe website. We use the data to improve the experience and simplify the process for users like you.

Comments


Log In / Sign Up


Already have a Schedule or Mobile App?

Don't have an account?

Sign Up




You need to be logged in to bookmark posters, save notes, or rate posters.