You are working a busy shift in the emergency department and are trying to quickly disposition patients. As the shift progresses and your feet hurt, you wonder why your work space is far removed from the patient care area, and different walls have bins that contain order sets, handover notes, and referral forms. Moreover, the route to sending the tube to the lab crosses too close to the dirty utility room. You think …
What to Do in a Resuscitation as a Junior Learner
Background If you’re a medical student interested in emergency medicine, it’s a pretty safe bet that you’re also interested in resuscitation medicine. It’s a defining aspect of the specialty — how to take a sick, undifferentiated patient and simultaneously investigate and treat a potentially very broad differential diagnosis. The challenge is that, as a junior learner, you’ve likely received limited teaching in resuscitation medicine, and what teaching you have received is probably more …
HiQuiPs: Preparing a QI Manuscript – the SQUIRE 2.0 Guidelines
You are planning to conduct a quality improvement project and your project supervisor has advocated that you download a copy of the SQUIRE 2.0 QI reporting guidelines before you begin. This is confusing, as it seemed to you that reporting guidelines governed how a manuscript should be drafted rather than how a project should be conducted. You decide to take a deeper dive into the SQUIRE 2.0 guidelines. Introduction: Guidelines for Conducting Research …
A Junior Learner’s Approach to Dealing with Difficult Situations during Patient Care
Why is this topic important? As a learner, you will inevitably experience “difficult” encounters during patient care. In fact, clerks and junior residents are more likely to label patient encounters as “difficult”.1 These encounters often involve patients that refuse to answer questions, use profanity, demand specific investigations or treatments, and express frustration with wait times. But why is it important for clerks and junior residents to learn how to handle difficult encounters with …
HiQuiPs Special Post: In Situ Simulation and High Reliability Organizations in the time of COVID-19
It has been a slower than usual night shift, and you have just led a resuscitation for a COVID-19 patient in your ED. Your ED has experienced several policy changes in recent weeks, from new standards for the use of personal protective equipment to policies for mitigating risk during aerosol-generating medical procedures to guidelines on how to best communicate between resuscitation and support teams. You wonder how your department can implement multiple changes …
How to Read and Make Statistical Process Charts – Part 1
You are attending your monthly ED business meeting. There has been a recent effort to decrease the time it takes a patient to be transferred to the imaging department for a STAT CT scan. The project team has concluded the first two PDSA cycles after wide stakeholder engagement, and a root cause analysis. Two interventions were carried out: one, redesigning the process for patient pick up and transport, and two, a new expedited …