It is a sad commentary on ED's across the country when extremely crowded clinical conditions are being seen as the norm. It's been shown that crowding negatively impacts patient satisfaction, delays the administration of pain medicines, and increases patient mortality.I'm working on a study that I conducted with my research associate Sandi, assessing whether a crowded clinical environment impacts teaching. This came up after writing a paper with Dr. Philip Shayne (Emory) on the sad state of literature looking at this question. We have many students, interns, and residents at the General, and anecdotally faculty find that there is less teaching when there are just too many clinical "fires" to put out simultaneously.
In our study, Sandi furtively recorded the clinical activities of 19 attendings over the past few months. I've seen her creatively listen from behind curtains, hide around corners but still within earshot, and generally look busy with other duties. I think she was a spy in a former life... I just sent the data to the statisticians. We'll see.
