Evaluation of Difference in Emergency Care Quality by Years of Physician Experience at the Emergency Department.

Juntendo Iji Zasshi Pub Date : 2024-09-30 eCollection Date: 2024-01-01 DOI:10.14789/jmj.JMJ24-0035-OA
Shungo Tokunaga, A I Ikeda, Daisuke Usuda, Kenji Kawai, Riki Sakurai, Shiho Tsuge, Shun Matsubara, Makoto Suzuki, Risa Tanaka, Shintaro Shimozawa, Yuta Hotchi, Ippei Osugi, Akihiko Kondo, Kentaro Mishima, Keiko Mizuno, Takayuki Komatsu, Hiroki Takami, Jiro Oba, Tomohisa Nomura, Manabu Sugita
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Abstract

Objective: To evaluate the effect of emergency medicine training credentials and years of medical experience on various clinical parameters in emergency medicine practice.

Methods: A cross-sectional study was conducted at Juntendo University Nerima Hospital between 1 April 2019 and 31 March 2020. All patients who were transported by ambulance, were examined by emergency physicians, and underwent computed tomography (CT) or magnetic resonance imaging (MRI) in the emergency department were included. For these cases, data on the attending physician's qualification status and experience (specialist, nonspecialist with 1-2 years of experience, or nonspecialist with 3-4 years of experience), clinical parameters, and imaging were collected. The primary outcome was the patient's total length of stay (LOS) in the emergency department.

Results: A total of 3,784 patients were included in the study. Patients attended by nonspecialists with 1-2 years of experience had a significantly longer time from arrival to assessment and LOS, especially in mild and severe cases and cases requiring head and abdominal CT imaging.

Conclusion: Our findings suggest that for physicians with minimal work experience, mentorship and effective training using triage flow and medical examination protocols may help to reduce LOS in the emergency department.

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评估急诊科医生从业年限对急诊护理质量的影响。
目的评估急诊医学培训证书和医疗经验年限对急诊医学实践中各种临床参数的影响:顺天堂大学练马医院于 2019 年 4 月 1 日至 2020 年 3 月 31 日期间开展了一项横断面研究。所有由救护车运送、接受急诊医生检查并在急诊科接受计算机断层扫描(CT)或磁共振成像(MRI)的患者均被纳入研究范围。在这些病例中,收集了主治医生的资质状况和经验(专科医生、有 1-2 年经验的非专科医生或有 3-4 年经验的非专科医生)、临床参数和成像数据。主要结果是患者在急诊科的总住院时间(LOS):研究共纳入了 3784 名患者。由具有 1-2 年经验的非专科医生接诊的患者,从到达急诊科到进行评估和住院时间明显更长,尤其是轻度和重度患者,以及需要进行头部和腹部 CT 成像检查的患者:我们的研究结果表明,对于工作经验不足的医生来说,利用分诊流程和医疗检查规程进行指导和有效培训可能有助于缩短急诊科的住院时间。
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审稿时长
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