Matching Items (5)
Filtering by
- All Subjects: Empathy
- All Subjects: Emergency Rooms
- Creators: Robert, Jason
Description
This long form creative nonfiction essay gives insider details on working in an emergency room as a medical scribe. The most pertinent topic is death and how the author copes with seeing patients die on a regular basis. Other topics are emergency room procedures, specific diagnoses and treatments, as well information on the other personnel in an emergency room.
ContributorsFeller, Aaron Lee (Author) / Gutkind, Lee (Thesis director) / Robert, Jason (Committee member) / Rowe, Todd (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / Department of English (Contributor)
Created2013-05
Description
There is growing concern among physicians, scholars, medical educators, and most importantly among patients, that science and technology have begun to eclipse fundamental attributes, such as empathy in the doctor-patient relationship. As a result, “humanism” in medicine has been a widely debated topic—how to define it, how to promote it, whether it can be taught, and how to qualify (much less quantify) its value in the practice of medicine. Through this research project I sought to better understand the role of humanities coursework in American medical school curricula, and determine whether there was a relationship between the integration of humanities coursework and the maintenance or enhancement of empathy levels in medical students. I reviewed literature with three objectives. (1) To better understand the influential social and political factors of pervasive reforms in US medical school curricula at the beginning of the 20th century, which led to science exclusive pedagogy in physician training (2) To become familiar with the works of iconic personalities in the history of American medical school pedagogy, paying special attention to attitudes and claims describing the role of humanities coursework, and the concept of humanism in the practice of medicine. (3) To observe the discourse underway across a variety of disciplines with regard to the current role of humanities coursework in medical curricula. My research shows that empathy is an essential attribute in the healing relationship, which benefits patients, physicians and improves health outcomes. Despite the importance of empathy, current physician training is documented as eroding empathy levels in medical students. Though the definition of ‘humanities’ in the context of medical school curricula remains vague and even contradictory, support for integration of humanities coursework is growing as an effective intervention for maintaining or enhancing levels of empathy.
ContributorsCraer, Jennifer Ryan (Author) / Maienschein; Lynch, Jane; John (Thesis director) / Ellison, Karin (Committee member) / Robert, Jason (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-05
Description
There is growing concern among physicians, scholars, medical educators, and most importantly among patients, that science and technology have begun to eclipse fundamental attributes, such as empathy in the doctor-patient relationship. As a result, “humanism” in medicine has been a widely debated topic—how to define it, how to promote it, whether it can be taught, and how to qualify (much less quantify) its value in the practice of medicine. Through this research project I sought to better understand the role of humanities coursework in American medical school curricula, and determine whether there was a relationship between the integration of humanities coursework and the maintenance or enhancement of empathy levels in medical students. I reviewed literature with three objectives. (1) To better understand the influential social and political factors of pervasive reforms in US medical school curricula at the beginning of the 20th century, which led to science exclusive pedagogy in physician training (2) To become familiar with the works of iconic personalities in the history of American medical school pedagogy, paying special attention to attitudes and claims describing the role of humanities coursework, and the concept of humanism in the practice of medicine. (3) To observe the discourse underway across a variety of disciplines with regard to the current role of humanities coursework in medical curricula. My research shows that empathy is an essential attribute in the healing relationship, which benefits patients, physicians and improves health outcomes. Despite the importance of empathy, current physician training is documented as eroding empathy levels in medical students. Though the definition of ‘humanities’ in the context of medical school curricula remains vague and even contradictory, support for integration of humanities coursework is growing as an effective intervention for maintaining or enhancing levels of empathy.
ContributorsCraer, Jennifer Ryan (Author) / Maienschein; Lynch, Jane; John (Thesis director) / Ellison, Karin (Committee member) / Robert, Jason (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-05
Description
The medical scribe industry is relatively new and populated with pre-medical students trying to gain the necessary experience to be considered qualified candidates for medical school. However, with the emergence of any new industry, there are bound to be flaws in the infrastructure of the position. I chose to investigate the discrepancies between what medical scribe companies were advertising to attract pre-medical students and what pre-medical students reported that they were gaining from the experience. I used qualitative content analysis and a deductive research design based on my own experience and the experience of my fellow scribes. I looked at how medical scribing affected pre-medical students and what struggles they faced when working as a medical scribe. I found that while students reported many negative components of scribing, and that medical scribing companies did not prepare their applicants well for those challenges, most scribes still expressed a significant education benefit to the experience which outweigh the drawbacks. Lastly, I propose the importance of narrative medicine in helping to deal with the hardships of the position and how narrative medicine can serve as a tool for self-reflection on the path to making the next generation of physicians.
ContributorsStefaniak, Pauline (Author) / Robert, Jason (Thesis director) / O'Neil, Erica (Committee member) / Truten, Jack (Committee member) / School of Politics and Global Studies (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Declaration of Conflicts: This project has no conflicts of interest to declare.
Context: This project was completed at a federally qualified primary healthcare clinic in Phoenix, Arizona that served patients of all age groups, but primarily cared for the Hispanic population providing primary care, preventative services, family planning, two lab technicians, one promoter, two medical assistant supervisors, five front desk staff, one chief administrative officer, one chief financial officer, two medical directoers who were also providers at the clinic.
Problem and Analysis Assessment: During my clinical rotations, I saw the burden a missed patient appointment had not only on the patients themselves, but also on the clinic, providers, and the staff. It caused delay in treatment for patients, and it did not allow other patients that wanted to be seen to be seen. It also increased unnecessary costs and wasted provider time. Thereafter, I met with some of the leadership team and one of the medical directors to determine a solution to reduce the number of missed appointments that were occurring. An educational session was kept to discuss the findings of this problem to the providers and the staff and when surveys were handed out to the patients, providers, and staff to assess their satisfaction with the old scheduling system versus the new scheduling system, they were also provided with a cover letter discussing the project.
Intervention: In order for improvements in care to occur, a system process change including the way patients are scheduled must occur. In this case, an open-access scheduling system (OAS) was implemented. OAS allows a patient to schedule an appointment on the 'same-day' or the 'next-day' to be seen. One provider at each of the clinics, each day of the week was available for 'same-day' appointments from 1300-1600. The providers were still available for scheduled appointments using the previous scheduling method. Walk-ins were still accepted, and were scheduled based on patient provider preference; however, if an appointment was not available for their preferred provider, they were typically seen with the provider that was the 'same-day' provider for that day.
Strategy for change: Since patients were only allowed to schedule appointments one month in advance, only one month was needed to implement this process change. A recommendation for the future would be to clearly identify the patient encounter type, and label it as a same-day appointment, as this would be helpful when gathering and extracting data for this type of patient group specifically.
Measurement of Improvement: Over a three-month period, a data collection plan was used to determine the number of Mas over a three-month period before and after implementation of this change. Satisfaction scores were measured using likert scales for patients, provider, and staff, and a dichotomous scale was used to determine the likelihood of emergency room or urgent care use. A comparison was done to measure revenue during the same time frame. During the three months, a clinically significant decrease in MAs was seen (<0.52%), with an increase in revenue by 41%. Additionally, a statistically significant increase in patient, provider and staff satisfaction was also noted when compared to the old scheduling system, as >68% of all patients, providers and staff reported feeling either very satisfied or extremely satisfied with the new scheduling system. Additionally, patients also reported that they were less likely to visit an emergency room(88%) or urgent care (90%) since they were able to be seen the same-day or the next-day by a provider.
Effects of changes: An incidental finding occurred during this study - where 877 more patients were seen in the three months during the implementation of this project, compared to the three months prior; which likely resulted in a 41% increase in revenue. Additionally this project, allowed patients that wanted to be seen on the same day, to be seen, and it decreased unnecessary costs associated with emergency room or urgent care visits. Some of the limitations involved included the current political environment, appointment slots that were previously 15 minutes in length (in 2016), increased to 20 minutes in length (in 2017), a language barrier was noted for the patient surveys since English was not the first language for many of the patients who completed the survey (although documents were translated), and the surveys used were not reliable instrument given that a reliable instrument in previous studies could not be found.
Lessons learnt: In order to have accuracy of the survey results, it is best for the author of the study to hand out and provide scripture for the survey so that complete data is received from the surveyors.
Messages for others: Begin by making a small process change where only one provider allows for the open-access scheduling so that the entire office is not affected by it, and if results begin to look promising then it can be expanded. Additionally, correct labeling of patients as 'same-day' is also important so that additional data can be gathered when needed regarding the 'same-day' patients.
Patient/Family/Guardian Involvement: Patients who benefited from the new scheduling system (open-access scheduling) were asked to fill out a survey that asked them to disclose some demographic data and asked them to determine their satisfaction with the new vs old scheduling system and their likelihood of visiting an emergency room or urgent care.
Ethics Approval: Arizona State University Institutional Review Board (IRB) Received: September 2017
Context: This project was completed at a federally qualified primary healthcare clinic in Phoenix, Arizona that served patients of all age groups, but primarily cared for the Hispanic population providing primary care, preventative services, family planning, two lab technicians, one promoter, two medical assistant supervisors, five front desk staff, one chief administrative officer, one chief financial officer, two medical directoers who were also providers at the clinic.
Problem and Analysis Assessment: During my clinical rotations, I saw the burden a missed patient appointment had not only on the patients themselves, but also on the clinic, providers, and the staff. It caused delay in treatment for patients, and it did not allow other patients that wanted to be seen to be seen. It also increased unnecessary costs and wasted provider time. Thereafter, I met with some of the leadership team and one of the medical directors to determine a solution to reduce the number of missed appointments that were occurring. An educational session was kept to discuss the findings of this problem to the providers and the staff and when surveys were handed out to the patients, providers, and staff to assess their satisfaction with the old scheduling system versus the new scheduling system, they were also provided with a cover letter discussing the project.
Intervention: In order for improvements in care to occur, a system process change including the way patients are scheduled must occur. In this case, an open-access scheduling system (OAS) was implemented. OAS allows a patient to schedule an appointment on the 'same-day' or the 'next-day' to be seen. One provider at each of the clinics, each day of the week was available for 'same-day' appointments from 1300-1600. The providers were still available for scheduled appointments using the previous scheduling method. Walk-ins were still accepted, and were scheduled based on patient provider preference; however, if an appointment was not available for their preferred provider, they were typically seen with the provider that was the 'same-day' provider for that day.
Strategy for change: Since patients were only allowed to schedule appointments one month in advance, only one month was needed to implement this process change. A recommendation for the future would be to clearly identify the patient encounter type, and label it as a same-day appointment, as this would be helpful when gathering and extracting data for this type of patient group specifically.
Measurement of Improvement: Over a three-month period, a data collection plan was used to determine the number of Mas over a three-month period before and after implementation of this change. Satisfaction scores were measured using likert scales for patients, provider, and staff, and a dichotomous scale was used to determine the likelihood of emergency room or urgent care use. A comparison was done to measure revenue during the same time frame. During the three months, a clinically significant decrease in MAs was seen (<0.52%), with an increase in revenue by 41%. Additionally, a statistically significant increase in patient, provider and staff satisfaction was also noted when compared to the old scheduling system, as >68% of all patients, providers and staff reported feeling either very satisfied or extremely satisfied with the new scheduling system. Additionally, patients also reported that they were less likely to visit an emergency room(88%) or urgent care (90%) since they were able to be seen the same-day or the next-day by a provider.
Effects of changes: An incidental finding occurred during this study - where 877 more patients were seen in the three months during the implementation of this project, compared to the three months prior; which likely resulted in a 41% increase in revenue. Additionally this project, allowed patients that wanted to be seen on the same day, to be seen, and it decreased unnecessary costs associated with emergency room or urgent care visits. Some of the limitations involved included the current political environment, appointment slots that were previously 15 minutes in length (in 2016), increased to 20 minutes in length (in 2017), a language barrier was noted for the patient surveys since English was not the first language for many of the patients who completed the survey (although documents were translated), and the surveys used were not reliable instrument given that a reliable instrument in previous studies could not be found.
Lessons learnt: In order to have accuracy of the survey results, it is best for the author of the study to hand out and provide scripture for the survey so that complete data is received from the surveyors.
Messages for others: Begin by making a small process change where only one provider allows for the open-access scheduling so that the entire office is not affected by it, and if results begin to look promising then it can be expanded. Additionally, correct labeling of patients as 'same-day' is also important so that additional data can be gathered when needed regarding the 'same-day' patients.
Patient/Family/Guardian Involvement: Patients who benefited from the new scheduling system (open-access scheduling) were asked to fill out a survey that asked them to disclose some demographic data and asked them to determine their satisfaction with the new vs old scheduling system and their likelihood of visiting an emergency room or urgent care.
Ethics Approval: Arizona State University Institutional Review Board (IRB) Received: September 2017
ContributorsPatel, Dimple (Author) / Thrall, Charlotte (Thesis advisor) / Glover, Johannah-Uriri (Thesis advisor)
Created2018-05-02