Supplementary Files
Keywords
Work Environment
Stress
Crowding
How to Cite
Abstract
Background: In Denmark, there has been an increase in patient admissions to Emergency Medicine Departments, resulting in increased pressure on the work environment. At the Department of Emergency Medicine at Aalborg University Hospital, a smartphone application (app) for coordinating patient flow was tested to evaluate its potential to optimize workflow and thereby improve the work environment.
Methods: A QR code linking to an electronic questionnaire was distributed in the department during the seven days before and the seven days after implementation of the app. The QR code and questionnaire were also mentioned at the daily morning meetings. Doctors and nurses answered the questions using a 0-100 visual analogue scale (VAS).
Results: Before implementation of the app, 61 employees (11 coordinators, defined as doctors and nurses responsible for coordinating patient flow) completed the questionnaire. After implementation, 51 employees responded (17 coordinators). The perceived work environment during crowding scored low before app implementation, with a median VAS score of 38 (Interquartile range (IQR): 16;50) among coordinators and 50 (IQR: 32;76) among non-coordinators on a 0-100 scale. The work environment significantly improved among coordinators after app implementation (median VAS score 70 (IQR: 51;82) versus 38 (IQR: 16;50), p-value = 0.005). Furthermore, a significant improvement in communication during crowding was observed among coordinators after app implementation (median VAS score 79 (IQR: 70;79) versus 58 (IQR: 35;71), p-value = 0.01). Permanent implementation of the app was desired by 71% of coordinators.
Conclusion: The work environment scores were generally low in the Department of Emergency Medicine at Aalborg University Hospital in Denmark. Implementation of a coordination app proved effective in improving both work environment and communication scores among coordinators. The external validity is expected to be high for other large Emergency Medicine Departments.
References
George G, Jell C, Todd BS. Effect of population ageing on emergency department speed and efficiency: A historical perspective from a district general hospital in the UK. Emergency Medicine Journal. 2006;23(5):379-383. doi:10.1136/emj.2005.029793
Larsen M, Jakobsen Vibeke. Arbejdskraftmangel Og Rekrutteringsudfordringer På de Store Velfærdsområder.; 2022.
Boesen H. Målet om de 1.000 ekstra sygeplejersker er opgivet. Sygeplejersken. Published 2023. Accessed March 27, 2024. https://dsr.dk/fag-og-udvikling/sygeplejersken/arkiv/sygeplejersken-argang-2023-nr-2/maalet-om-de-1000-ekstra-sygeplejersker-er-opgivet/
Madsen MH, Strandby MW. Det nationale forsknings- og analysecenter for velfærd. Akutmodtagelserne i Danmark. Forudsætninger, udfordringer og fremtidige pejlemærker. 2018 e-ISBN: 978-87-7119-549-1.
Klinefelter Z, Hirsh EL, Britt TW, George CL, Sulzbach M, Fowler LA. Shift Happens: Emergency Physician Perspectives on Fatigue and Shift Work. Clocks Sleep. 2023;5(2):234-248. doi:10.3390/clockssleep5020019
Tv2. Krise på Gødstrups akutafdeling: Læger er dødeligt bekymrede for patienters sikkerhed - TV 2. Tv2 Nyhederne [Internet]. 2023 [cited 2023 Mar 28]; Available from: https://nyheder.tv2.dk/lokalt/2023-01-13-krise-paa-goedstrups-akutafdeling-laeger-er-doedeligt-bekymrede-for-patienters.
Hansen SE. Krise på Gødstrups akutafdeling: Læger er dødeligt bekymrede for patienters sikkerhed. TV2. Published January 13, 2023. Accessed March 27, 2024. https://nyheder.tv2.dk/lokalt/2023-01-13-krise-paa-goedstrups-akutafdeling-laeger-er-doedeligt-bekymrede-for-patienters-sikkerhed
Dansk Sygeplejeråd. Bekymringsbrev fra 95 sygeplejersker: Vi går rundt med en knude i maven, er det i dag jeg overser noget? Published online 2023.
Mausner-Dorsch H, Eaton WW. Psychosocial work environment and depression: Epidemiologic assessment of the demand-control model. Am J Public Health. 2000;90(11):1765-1770. doi:10.2105/AJPH.90.11.1765
Dansk Sygeplejeråd. NOTAT Stress blandt sygeplejersker, 2018 [Internet]. 2018 [cited 2023 Mar 28]. Available from: https://dsr.dk/sites/default/files/24/notat_stress_blandt_sygeplejersker_sath_2018.pdf
Dansk Sygeplejeråd. Faglig forsvarlig sygepleje [Internet]. 2018 [cited 2023 Mar 28]. Available from: https://dsr.dk/sites/default/files/24/faglig_forsvarlighed_og_kvalitet_2018.pdf
Dansk Sygeplejeråd. Sygeplejerskernes oplevelser af arbejdspres [Internet]. 2018 [cited 2023 Mar 28]. Available from: https://dsr.dk/sites/default/files/24/notat_sygeplejerskers_oplevelse_af_arbejdspres_sath_2018.pdf
Blaabjerg M, Lisby M. Jobtilfredshed og arbejdsmiljø blandtdanske akutsygeplejersker. Klin Sygepleje. 2019 Dec 3;33(4):263–83. DOI:10.18261/ISSN.1903-2285-2019-04-02
Dansk Sygeplejeråd. Seks ud af ti sygeplejersker overvejer at skifte job | Politik og nyheder, DSR [Internet]. 2020 [cited 2023 Mar 28]. Available from: https://dsr.dk/politik-og-nyheder/nyhed/seks-ud-af-ti-sygeplejersker-overvejer-at-skifte-job
DR nyhederne. Sygeplejersken Charlotte sagde op, da hun for anden gang blev udpeget til coronaberedskabet: “Mine børn er vigtigere” | Midt- og Vestjylland | DR. 2020 [cited 2023 Mar 28]; Available from: https://www.dr.dk/nyheder/regionale/midtvest/sygeplejersken-charlotte-sagde-op-da-hun-anden-gang-blev-udpeget-til
Dansk Sygeplejeråd. Mange sygeplejersker overvejer nyt job | Kreds Midtjylland, DSR [Internet]. 2020 [cited 2023 Mar 28]. Available from: https://dsr.dk/kredse/midtjylland/nyhed/mange-sygeplejersker-overvejer-nyt-job
Clausen T, Madsen IEH, Christensen KB, Rugulies R et al. The Danish Psychosocial Work Environment Questionnaire (DPQ): Development, content, reliability and validity. Scand J Work Environ Health. 2019 Jul 1;45(4):356-369. doi:10.5271/sjweh.3793. Epub 2018 Dec 28.
Schooley B, Walczak S, Hikmet N, Patel N. Impacts of mobile tablet computing on provider productivity, communications, and the process of care. Int J Med Inform. 2016;88:62-70. doi:10.1016/j.ijmedinf.2016.01.010
Braagaard N. Fem infektioner lægger lige nu danskerne ned på stribe. TV2 November 16th 2023. https://nyheder.tv2.dk/samfund/2023-11-16-fem-infektioner-laegger-lige-nu-danskerne-ned-paa-stribe
Sharma H. How short or long should be a questionnaire for any research? Researchers dilemma in deciding the appropriate questionnaire length. Saudi J Anaesth. 2022;16(1):65-68. doi:10.4103/sja.sja_163_21
Flanagan ME, Saleem JJ, Millitello LG, Russ AL, Doebbeling BN. Paper- and computer-based workarounds to electronic health record use at three benchmark institutions. Journal of the American Medical Informatics Association. 2013;20(E1). doi:10.1136/amiajnl-2012-000982
Horng S, Goss FR, Chen RS, Nathanson LA. Prospective pilot study of a tablet computer in an Emergency Department. Int J Med Inform. 2012;81(5):314-319. doi:10.1016/J.IJMEDINF.2011.12.007
Roussel LA. On-the-Go Strategies to Enhance Resilience and Self-Care: Using Technology to Create Healthy Work Cultures. Nurs Clin North Am. 2022;57(4):501-512. doi:10.1016/J.CNUR.2022.06.002
Prgomet M, Georgiou A, Westbrook JI. The Impact of Mobile Handheld Technology on Hospital Physicians’ Work Practices and Patient Care: A Systematic Review. Journal of the American Medical Informatics Association. 2009;16(6):792-801. doi:10.1197/jamia.M3215
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