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Objectives: To compare patient satisfaction levels, staff perspectives and the time required using Structured Interdisciplinary Bedside Rounds (SIBR; Emory University, Atlanta, GA, USA) versus traditional medical ward rounds (TR) in the ED. Methods: We conducted an observational cross‐sectional study. Ward rounds were categorised into a modified SIBR and TR at a tertiary ED in Australia according to predefined criteria. We compared the duration of ward rounds, invited patients and staff to complete anonymous questionnaires to compare patient satisfaction and staff perspectives. Results: During the study period, SIBR group took significantly longer time than TR per patient (122 vs 88 s, P < 0.001). Patient questionnaires were completed for 320 encounters (101 SIBR, 219 TR). Patient satisfaction scores across all measured domains were significantly higher in SIBR than in the TR group. Patients often pointed out a lack of communication with medical staff during TR. Based on 131 completed staff questionnaires, nurses reported SIBR to be more useful than TR (nurses 78% vs doctors 44%, P = 0.001). The SIBR group had increased instances of staff introductions to patients (91% vs 66%, P < 0.001) and patients' involvement in discussion of management plans (98% vs 53%, P < 0.01). SIBR only weakly correlated with the overall positive experience in the ED (r = 0.19, P = 0.001). Organisational implementation issues raised through qualitative methods are reported in the paper. Conclusions: Our study highlights the benefits that could be gained through SIBR technique over the TR method. Better workforce and resource planning is needed to support the sustainable implementation of SIBR in ED. [ABSTRACT FROM AUTHOR]

Objectives In Australasia, emergency registrars usually gain experience 'running' an ED overnight - without supervision. This paper describes the introduction of FACEM-supervised daytime 'registrar in charge' ( RIC) shifts into a tertiary adult ED over a 6 month period. Methods Each registrar was allocated at least one RIC shift during their 13 week ED term. Structured questionnaires gathered data regarding the educational impact of the shifts, any adverse effects on departmental function, changes to work practices, and perceptions of teaching and learning. Data were analysed using thematic analysis. Results During the study period, 16 senior ED registrars were rostered for 26 RIC shifts. Questionnaires were completed by 16/16 registrars and 13/16 emergency physicians. The RIC shifts were viewed positively by the emergency registrars - 93% reported useful feedback, felt that the shifts provided a good insight into their workplace behaviour, and that they should be rolled out across other departments. FACEMs were also positive in their evaluation, and reported little negative impact on departmental function. Major themes identified by both registrars and emergency physicians included communication skills, knowledge and experience, delegation, professionalism and organisational skills. Additional themes that were more prominent in FACEM responses included multitasking, dealing with interruptions, managing patient flow and being aware of the whole department. Conclusions RIC shifts are a feasible and acceptable method to teach running the floor in the ED. Further study should assess impact on patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: To describe the reported impact of Pandemic (H1N1) 2009 on EDs, so as to inform future pandemic policy, planning and response management. Methods: This study comprised an issue and theme analysis of publicly accessible literature, data from jurisdictional health departments, and data obtained from two electronic surveys of ED directors and ED staff. The issues identified formed the basis of policy analysis and evaluation. Results: Pandemic (H1N1) 2009 had a significant impact on EDs with presentation for patients with 'influenza-like illness' up to three times that of the same time in previous years. Staff reported a range of issues, including poor awareness of pandemic plans, patient and family aggression, chaotic information flow to themselves and the public, heightened stress related to increased workloads and lower levels of staffing due to illness, family care duties and redeployment of staff to flu clinics. Staff identified considerable discomfort associated with prolonged times wearing personal protective equipment. Staff believed that the care of non-flu patients was compromised during the pandemic as a result of overwork, distraction from core business and the difficulties associated with accommodating infectious patients in an environment that was not conducive. Conclusions: This paper describes the breadth of the impact of pandemics on ED operations. It identifies a need to address a range of industrial, management and procedural issues. In particular, there is a need for a single authoritative source of information, the re-engineering of EDs to accommodate infectious patients and organizational changes to enable rapid deployment of alternative sources of care. [ABSTRACT FROM AUTHOR]