Addressing Workforce Challenges in the Emergency Department: Navigating the Storm

In the fast-paced environment of Emergency Departments (EDs), the challenges faced by healthcare professionals are immense. Task interruptions, multitasking, fatigue, and working memory demands are constant companions of emergency physicians, leading to a high rate of task errors and burnout. These challenges not only affect the well-being of the staff but also pose significant risks to patient safety.

Managing Multiple Patients in Emergency Medicine

• Frequent Interruptions: Emergency physicians experience 8-10 interruptions per hour, leading to an increased risk of medical errors.
• High Demand for Task-Switching and Multitasking: In the ED, doctors switch tasks 6 times per hour and multitask 9.2 times per hour, reflecting the intense nature of their work.
• Emergency Medicine's Unique Patient Management: Unlike primary care physicians who manage multiple patients for about 0.9 minutes per hour, emergency physicians face the challenge of managing multiple patients concurrently for an average of 37.5 minutes per hour. This highlights the unique and demanding nature of emergency medicine.
• The Challenge of Multitasking: As identified by Skaugset et al. (2016), true multitasking is difficult in emergency medicine. Rapid task-switching is more common but can lead to disruptions in primary tasks and an increase in errors.

Impact on Physician Well-being and Patient Safety

• Errors Due to Interruptions: Studies have shown that the high rate of interruptions in the ED significantly compromises task accuracy. For instance, clinicians recorded 208 errors in 239 medication orders primarily due to frequent interruptions. The error rate increased dramatically when physicians were interrupted (rate ratio [RR] 2.82) or multitasked (RR 1.86) while prescribing.
• Emergency Medicine and Burnout: The stressors in the ED contribute to a high burnout rate among physicians. The "Medscape Physician Burnout & Depression Report 2023" indicates that emergency medicine physicians have the highest burnout rate among all specialties, with 65% reporting burnout.

CyrenCare: Turning the Tide

In this challenging landscape, CyrenCare emerges as a transformative solution. By augmenting the medical information collection process and assisting with documentation, CyrenCare significantly reduces the cognitive load on emergency physicians, reducing burnout and enhancing overall patient safety. By implementing CyrenCare into the emergency department workflow, hospitals can take a significant step toward improving the work environment for their staff and ensuring higher-quality care for their patients.

1. Westbrook, J.I., Raban, M.Z., Walter, S.R., et al. (2018). Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study. BMJ Quality & Safety, 27, 655-663.

2. Walter, S.R., Li, L., Dunsmuir, W.T.M., et al. (2014). Managing competing demands through task-switching and multitasking: a multi-setting observational study of 200 clinicians over 1000 hours. BMJ Quality & Safety, 23, 231-241.

3. Skaugset, L.M., Farrell, S., Carney, M., et al. (2016). Can You Multitask? Evidence and Limitations of Task Switching and Multitasking in Emergency Medicine. Ann Emerg Med, 68, 189-195.

4. Chisholm, C.D., Collison, E.K., Nelson, D.R., et al. (2000). Emergency department workplace interruptions: are emergency physicians “interrupt-driven” and “multitasking”? Acad Emerg Med, 7, 1239-1243.

5. Chisholm, C.D., Dornfeld, A.M., Nelson, D.R., et al. (2001). Work interrupted: a comparison of workplace interruptions in emergency departments and primary care offices. Ann Emerg Med, 38, 146-151.

6. Medscape Physician Burnout & Depression Report 2023: 'I Cry and No One Cares'. [Online] Available at: Becker's Hospital Review