Published June 4, 2018
Technologies designed to track and eventually improve staffing levels in hospital emergency departments must be judiciously chosen, according to a new study published in the Journal of Emergency Nursing.
Overcrowded emergency departments are a public health crisis, limiting quality and access to lifesaving care, according to a study authored by Heidi N. Suffoleto, MD, clinical assistant professor of emergency medicine and orthopaedics.
Over four weeks, radio-frequency identification (RFID) tags were worn by doctors and nurses in a busy, urban teaching hospital emergency department (ED).
The introduction of wearable technology was motivated by a desire by clinical staff and the hospital to track and improve staffing when occupancy in the ED rises.
The goal was to see if wearable technologies that featured RFID tags could accurately measure clinician-patient contact and to examine how emergency department occupancy affects the amount of time doctors or nurses spend with patients.
The study found that attending-physician care became increasingly fragmented as occupancy increased, but it only amounted to a 4 percent difference in variability in how many encounters physicians had with patients compared to times when the ED wasn’t crowded.
While the total amount of time at the bedside didn’t change when the ED was crowded, the study found that time at the bedside was marked by more frequent interruptions and brief in-and-out visits.
The researchers found that using a device to track workflow can be helpful, but the device that was used in the study had certain limitations.
It didn’t work well in all treatment areas, often because of the built environment in the ED, including rooms with three walls, glass enclosures and frequent foot traffic.
RFIDs can also be placed on equipment in the ED to ensure that it can be located quickly and doesn’t leave the department when it is needed most.
“If interactions are interrupted or fragmented, patients recognize that they may not have the full attention of the physician/provider and feel that they are not being thoroughly heard,” she notes.
“This can lead to barriers with establishing trust, which can in turn impact care.”
The study, titled “Emergency Department Crowding and Time at the Bedside: A Wearable Technology Feasibility Study,” was published online April 25.
Jessica Castner, PhD, president of Castner Incorporated, is a co-author on the study.