Fink, B

Kakish, E

Kenney, K

Rega, P

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UC IrvineWestern Journal of Emergency Medicine: Integrating Emergency Care with Population HealthTitle“Secure-Preserve-Fight” or “Run-Hide- Fight”: Expectations of an Emergency Department Patient Population During an Active Assailant EventPermalinkhttps://escholarship.org/uc/item/12k2j55vJournalWestern Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 20(5.1)ISSN1936-900XAuthorsKakish, ERega, PFink, Bet al.Publication Date2019Copyright InformationCopyright 2019 by the author(s).This work is made available under the terms of a Creative Commons Attribution License, available at https://creativecommons.org/licenses/by/4.0/eScholarship.org Powered by the California Digital LibraryUniversity of CaliforniaWestern Journal of Emergency Medicine S19 Volume 20, Supplement : September 2019 MEMC Abstracts 2019the “likelihood to recommend” and “cleanliness” questions, respectively; 54.4% of patients reported waiting less than 15 minutes to see a physician. Patients in the intervention group had significantly higher mean scores on the validated post-visit survey compared to controls on questions regarding “likelihood to recommend” (4.21, confidence interval [CI] 4.03-4.38 vs 3.82, CI, 3.61-4.02, p = 0.01), overall rating (4.16, CI 4.00-4.33 vs 3.87, CI 3.68-4.06, p = 0.04), waiting time for provider (4.11, CI, 3.92-4.31 vs 3.81, CI 3.61-4.00, p = 0.01), and department cleanliness (4.09, CI, 3.91-4.27 vs 3.80, CI, 3.62-3.98, p = 0.02) (Table1).  Conclusion: An ED-oriented patient liaison program allowed for real-time feedback and opportunities for immediate service recovery, resulting in increased patient satisfaction ratings across multiple indicators.   Table 1. Patient experience ratings and 95% confidence inter-vals for patients encountered by patient navigators vs case-matched controls.  Control Intervention p-value“Likelihood to recommend”3.82 (3.61-4.02)4.21 (4.03-4.38)0.010*Overall 3.87 (3.68-4.06)4.16 (4.00-4.33)0.039*Wait time 3.81 (3.61-4.00)4.11 (3.92-4.31)0.012*Cleanliness 3.80 (3.62-3.98)4.09 (3.91-4.27)0.016*22 “Secure-Preserve-Fight” or “Run-Hide-Fight”: Expectations of an Emergency Department Patient Population During an Active Assailant Event Kakish E1, Rega P 2, Fink B2, Kenney K 2 / 1Department of Emergency Medicine, Henry Ford West Bloomfield, West Bloomfield, MI; 2Department of Emergency Medicine, University of Toledo, Toledo, OH Objective: We sought to assess the opinions of a general emergency department (ED) patient-family population regarding healthcare providers’ life-saving responsibilities during an active assailant event (the traditional “Run-Hide-Fight” paradigm [provider-centric] vs the novel “Secure-Preserve-Fight” [vulnerable patient-centric]) paradigm.  Design and Method:  This institutional review board-approved study presented a scenario-based questionnaire to a convenience sample of ED patients and their retinues. Demographic information included prior military service, formal active-shooter training, and prior violent victimization. The randomly selected subjects evaluated four typical patient scenarios of varying severity within which an emergency physician/nurse was in immediate proximity. They were provided four responses addressing their expectations regarding the healthcare provider’s actions: provider-centric (namely, “Run-Hide-Fight), or patient-centric (that is, Secure-Preserve-Fight). The frequency of each response was the primary outcome. We employed a non-parametric binomial test as well as SPSS (IBM, Chicago, IL)Conclusion: For this particular ED population, a significant majority supported the patient-centric “Secure-Preserve-Fight” paradigm over the more provider-centric “Run-Hide-Fight” option. This lay public perspective should spur healthcare staff and administration to reconsider their current active shooter plans and possibly modify them to be consistent with “Secure-Preserve-Fight,” especially when dealing with the vulnerable patient. 23 Burnout in Resident Physicians: Correlation with Mistreatment and Workplace ViolenceNorvell JG, Dougherty K, Behravesh B, Nazir N, and Unruh G / University of Kansas Medical Center, Kansas City, KS Background: Research studies show a high burnout level among physicians. Research also shows that mistreatment of medical trainees and workplace violence have potentially long-term, negative effects on the individual. This study examines the correlation between resident burnout and the self-reported incidence of mistreatment and workplace violence.Methods: Each year, the University of Kansas Medical Center Graduate Medical Education Wellness Subcommittee administers a wellness survey to all 560 residents and fellows. The 71-question electronic survey was originally developed at Stanford University Medical Center. We obtained institutional review board approval for this study..Results: Of 560 residents and fellows from various specialties who received the survey, 393 completed it (70% response rate); the responses included 147 from female residents (37%) and 246 from males (63%). We found that 20.4% of all resident surveys had responses indicative of burnout. Of the 16 emergency medicine (EM) residents who completed the survey, we found a 37.5% burnout rate. Overall, 35 residents reported being publicly humiliated, and they had a significantly higher burnout rate than those who did not (62.9% vs 16.9%; p value = <0.0001). We also found the following: 55 residents reported being publicly embarrassed, and they had a higher burnout rate than those who did not (52.6% vs 15.5%; p value = <0.0001); 23 residents reported being subjected to offensive sexist 

“Secure-Preserve-Fight” or “Run-Hide- Fight”: Expectations of an Emergency Department Patient Population During an Active Assailant Event

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