AEM Early Access

AEM Early Access 28: A cross-sectional analysis of compassion fatigue, burnout and compassion satisfaction in pediatric emergency medicine physicians in the US

Welcome to the twenty-eighth episode of AEM Early Access, a FOAMed podcast collaboration between the Academic Emergency Medicine Journal and Brown Emergency Medicine. Each month, we'll give you digital open access to an recent AEM Article or Article in Press, with an author interview podcast and suggested supportive educational materials for EM learners.

Find this podcast series on iTunes here.

AEM Podcasts logo[3].png

DISCUSSING (CLICK ON LINK FOR FULL TEXT, OPEN ACCESS THROUGH JULY 31):

A cross-sectional analysis of compassion fatigue, burnout and compassion satisfaction in pediatric emergency medicine physicians in the US. Jeanie Gribben, BS, Samuel Kase, BA, Elisha Waldman, MD, and Andrea Weintraub, MD.

LISTEN NOW: AUTHOR INTERVIEW WITH Jeanie Gribben, BS AND Andrea WeintrauB, MD

Gribben_Headshot_2019.png

Jeanie Gribben, BS

Fourth-year medical student, Icahn School of Medicine at Mount Sinai

Andrea Weintraub Headshot.jpg

Andrea Weintraub, MD

Associate Professor of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai


ABSTRACT:

Objectives: To determine the prevalence of compassion fatigue, burnout, and compassion satisfaction and identify potential personal and professional predictors of these phenomena in pediatric critical care providers.

Design: Cross-sectional, online survey.

Setting: Pediatric critical care practices in the United States.

Subjects: Pediatric critical care fellows and attending physicians.

Interventions: None.

Measurements and Main Results: A modified Compassion Fatigue and Satisfaction Self-Test for Helpers and a questionnaire of personal and professional characteristics were distributed electronically to pediatric critical care physicians nationally. Prevalence of these phenomena was calculated. Hierarchical linear regression models for compassion fatigue, burnout, and compassion satisfaction as a function of potential risk factors were constructed. The survey response rate was 35.7%. The prevalence of compassion fatigue, burnout, and compassion satisfaction was 25.7%, 23.2%, 16.8%, respectively. Burnout score, emotional depletion, and distress about a patient and/or the physical work environment were each significant determinants of higher Compassion Fatigue scores. Preparing for didactics, Compassion Fatigue score, distress about administrative issues and/or coworkers, and "self-care is not a priority" were each significant determinants of higher burnout scores, whereas female sex, Compassion Satisfaction score, and distress about the physical work environment were each significant determinants of lower burnout scores. Prayer/meditation, talking with colleagues, senior faculty level, and student and/or chaplain involvement when delivering bad news were each significant predictors of higher Compassion Satisfaction scores, whereas female sex, burnout score, emotional depletion, and distress about coworkers were each significant predictors of lower Compassion Satisfaction scores.

Conclusions: In our population, chronic exposure to distress in patients and families puts pediatric critical care physicians at risk for compassion fatigue and low compassion satisfaction. Awareness of compassion fatigue, burnout, and compassion satisfaction and their predictors may benefit providers both personally and professionally by allowing them to proactively manage their distress.

AEM Education and Training 12: Attitudes, Behavior, and Comfort of Emergency Medicine Residents in Caring for LGBT Patients: What do we know?

Welcome to the twelfth episode of AEM Education and Training, a podcast collaboration between the Academic Emergency Medicine E&T Journal and Brown Emergency Medicine. Each quarter, we'll give you digital open access to AEM E&T Articles or Articles in Press, with an author interview podcast and links to curated supportive educational materials for EM learners and medical educators.

Find this podcast series on iTunes here.

DISCUSSING (CLICK ON TITLE TO ACCESS):

Attitudes, Behavior, and Comfort of Emergency Medicine Residents in Caring for LGBT Patients: What Do We Know? Joel Moll MD, Paul Krieger MD, Sheryl L. Heron MD MPH, Cara Joyce PhD, Lisa Moreno‐Walton MD

LISTEN NOW: INTERVIEW WITH FIRST AUTHOR Joel Moll, MD, FACEP

Joel Moll, MD, FACEP

Residency Program Director

Associate Professor

Department of Emergency Medicine

Virginia Commonwealth University School of Medicine

Abstract

Background

Although lesbian, gay, bisexual, and transgender (LGBT) patients are ubiquitous in emergency medicine (EM), little education is provided to EM physicians on LGBT health care needs and disparities. There is also limited information on EM physician behavior, comfort, and attitudes toward LGBT patients. The objective of this study was to assess EM residents behavior, comfort, and attitudes in LGBT health.

Methods

An anonymous survey link was sent to EM programs via the Council of Residency Director listserv. The primary outcome of the 24‐item descriptive survey was the self‐reported comfort levels and self‐reported practice in LGBT health care. Secondary outcomes included individual comfort toward LGBT colleagues and patients who are LGBT, and the frequency of colleagues making discriminatory statements toward LGBT patients and staff in the emergency department setting. Associations between personal and program demographics and survey responses were also examined.

Results

There were 319 responses The majority of respondents were male (63.4%), Caucasian (69.1%), and heterosexual (92.4%). A sizeable minority of respondents felt histories and physical examinations were more challenging for lesbian, gay, or bisexual patients (24.6%) and more so for transgender patients (42.6%). Most residents do not ask patients to identify sexual orientation when presenting with abdominal or genital complaints (63%). Discriminatory LGBT comments were reported from both fellow residents (16.6%) and faculty (10%). A total of 2.5% of respondents were uncomfortable with other LGBT physicians, and 6% did not agree that LGBT patients deserve the same quality care as others.

Conclusion

A number of residents find caring for LGBT patients more challenging than heterosexual patients. Even with professed comfort with LGBT health care, most residents report taking incomplete sexual histories that may affect patient care. Attitudes toward LGBT patients are mainly, but not completely, positive in this cohort.

AEM Early Access 27: Capturing Emergency Department Discharge Quality with the Care Transitions Measure: A Pilot Study

Welcome to the twenty-seventh episode of AEM Early Access, a FOAMed podcast collaboration between the Academic Emergency Medicine Journal and Brown Emergency Medicine. Each month, we'll give you digital open access to an recent AEM Article or Article in Press, with an author interview podcast and suggested supportive educational materials for EM learners.

Find this podcast series on iTunes here.

AEM+Podcasts+logo[3].png

DISCUSSING (CLICK ON LINK FOR FULL TEXT, OPEN ACCESS THROUGH JUNE 30):

Capturing Emergency Department Discharge Quality with the Care Transitions Measure: A Pilot Study. Amber K. Sabbatini MD, MPH, Fiona Gallahue MD, Joshua Newson MD, Stephanie White, Thomas Gallagher MD

LISTEN NOW: AUTHOR INTERVIEW WITH Amber K. Sabbatini MD, MPH



myprofilephoto.jpg

Amber K. Sabbatini MD, MPH

Assistant Professor

Department of Emergency Medicine

University of Washington



Abstract

Background: Recent attention has been given to developing measures to capture the quality of ED transitions of care. We examined the utility of a patient-reported measure of transitional care, the Care Transitions Measure - 3 (CTM-3) in the ED setting and its association with outcomes of care after ED discharge.

Methods: Telephone survey of a convenience sample of patients 14 days after discharge from 2 emergency departments in an academic health system. Patients responded to 3 statements using a 4-point agreement scale (Strongly Disagree, Disagree, Agree, Strongly Agree): 1) "The hospital staff took my preferences and those of my family or caregiver into account when deciding what my healthcare needs would be" 2) " When I left the ER, I had a good understanding of the things I was responsible for in managing my health, and 3) "When I left the hospital, I clearly understood the purpose for taking each of my medications." Patients were also queried about outcomes after ED discharge that are known to be related to ED care transitions including medication adherence, completion of recommended follow-up and return visits to the ED. Multivariable logistic regression was used to determine the association between the CTM-3 score (on a 100-point scale) and outcomes of interest.

Results: Among 1832 patients called, 576 were reached by phone, and 410 consented and completed our survey, representing a 22.4% response rate of patients we attempted to call. A 10-point increase in the CTM-3 score (better care experiences) was associated with a 12% decrease in the odds of having an ED return visit (AOR 0.88, 95% CI 0.77-1.00) and a 45% increase in the odds of taking prescribed medications as recommended (AOR 1.45; 95% CI 1.12-1.87). There was no association between CTM-3 score and completion of follow-up.

Conclusions: The CTM-3 is associated with outcomes of care after an ED visit, including ED return visits and medication adherence, and may have utility as a patient-reported measure of ED transitions of care. This article is protected by copyright. All rights reserved.