RESUMO
Objectives The primary objective of this study was to evaluate the impact of an electronic tracking board feature encouraging staff to prompt optimal patient location on total stretcher time (TST) amongst patients moved to a chair in an internal emergency department (ED) waiting room. As a secondary objective, we also sought to identify facilitators and barriers to the tool's use amongst the ED staff. Methods Using an administrative database, a retrospective cohort design was used to compare TST between visits where the tool was used and not used amongst patients relocated from initial assessment space to a chair over an 11.5 month period. A mixed-methods design was used to investigate facilitators and barriers to the tool's use amongst the ED staff. Response proportions were used to report Likert scale questions; thematic analysis was used to code themes. Results A total of 56,852 patients met the inclusion criteria and were moved to a chair. The tool was used 4,301 times, with "OK for chairs" selected for 3,917/56,852 (6.9%) patients and "not OK for chairs" selected 384/56,852 (0.7%) times. Patient characteristics were similar between both groups. Median interquartile range (IQR) TST amongst patients moved to a chair via the prompt was shorter than when the prompt was not used (148.2 (112.6) mins vs 154.4 (115.4) mins, p = 0.005). A total of 125 questionnaires were completed; 95% of staff were aware of the tool and 70% agreed/strongly agreed the tool could improve ED flow. Commonly reported physician barriers to use were forgetting to use the tool; common nursing barriers were lack of chair space and increased workload. Conclusions Despite low function use, prompt use was associated with reduced TST amongst ED patients relocated to a chair.
RESUMO
OBJECTIVE: To examine whether the discipline (family medicine vs other specialty) of formally assigned faculty advisors affected medical student experience and career interest. DESIGN: Survey. SETTING: University of Calgary in Alberta. PARTICIPANTS: A total of 104 medical students from the graduating class of 2011. MAIN OUTCOME MEASURES: Number of times medical students met with their advisors, topics of discussions, interest in family medicine, and overall medical school experience. For binary categorical variables, χ2 tests of significance were computed, and t tests were used for count and Likert-scale variables. RESULTS: Overall, 89 (86%) surveys were returned. Significant differences were noted when the discipline of the faculty advisor (family medicine vs Royal College specialty) was considered. Family medicine faculty advisors met with their students more often (P = .03) and were more likely to have a beneficial effect on the medical school experience (P = .005). Having a relationship with a family medicine faculty advisor significantly increased family medicine career interest (P = .01), although a faculty advisor in any other discipline did not erode family medicine interest. The discipline of the faculty advisor had no statistically significant influence on a student's intended selection of family medicine in the Canadian Resident Matching Service match. CONCLUSION: Family medicine faculty advisors appear particularly active in their role as mentors and appear beneficial to the medical student experience. Career interest in family medicine was enhanced by being paired with a family medicine advisor and not eroded by an advisor from another specialty.
