SREMI Summer Student Report
This summer, Linor Berezin, a second year medical student at the University of Toronto joined the SREMI team as a research student. Linor previously completed a biochemistry degree at Queen’s University, and has been volunteering with SREMI since January 2018 to recruit patients for various studies in the emergency department. Working together with Shelley McLeod, Cameron Thompson, Vanessa Rojas-Luengas, and Dr. Bjug Borgundvaag, Linor worked on a retrospective chart review to determine the rates of spinal imaging and narcotic prescription for patients presenting to the emergency department with non-traumatic low back pain with no red flags or pathologic indicators. Linor thoroughly enjoyed the opportunity to participate in emergency department research and looks forward to developing a manuscript for this study and presenting the results at the Canadian Association of Emergency Physicians Conference 2019.
This summer, Sophie Glanz, a 3rd year medical student at the University of Toronto, worked under the supervision of Dr. Don Melady, Dr. Michelle Nelson and Shelley McLeod to complete a scoping review of volunteer services implemented in the emergency department to improve patient experience and/or outcomes. The review was inspired by Maximizing Ageing Using Volunteer Engagement in the Emergency Department (MAUVE-ED), a volunteer program at Mount Sinai Hospital that uses specially trained volunteers to help with non-clinical tasks for the geriatric population. The goals of the program included improving patient and caregiver experience by targeting core needs, which also overlap with risk factors for delirium. Sophie is planning to share the results of her review at CAEP 2019 in Halifax.
Second year University of Toronto medical student Robin Glicksman joined the SREMI research team this summer working on a project to better characterize the care of women experiencing early pregnancy complications in Ontario EDs. Under the supervision of Dr. Catherine Varner, Dr. Jackie Thomas and Shelley McLeod, Robin surveyed chief emergency medicine physicians and chief obstetricians/gynaecologists about access to early pregnancy clinic services, psychosocial supports, ultrasound availability and follow-up protocols for women who present to the hospital ED with first trimester complications. This study found that less than half of the hospitals surveyed had access to an early pregnancy clinic, demonstrating the need for better delivery care models for women experiencing first trimester complications in Ontario EDs.
Hanna Jalali is a second year medical student at the University of Toronto, who worked on the evaluation of the Ontario Emergency Department Return Visit Quality Program (RVQP) that was started by Health Quality Ontario (HQO) in 2016. The purpose of this program was to promote a culture of continuous quality improvement in the ED, and to reduce misdiagnosis and other factors that increase the risk of return visits. Participation in the program was mandatory for hospitals participating in the provincial pay-for-results program (although funds were not tied to performance). The program was also open to hospitals on a voluntary basis, and in total, 89 sites were involved. Hanna conducted phone interviews to gain perspectives and feedback from those involved in the program across the province. In partnering with HQO to assess their project, we hope to determine the efficacy of this type of large-scale intervention in promoting quality improvement culture in EDs in the province. This data will be primarily of interest to HQO, but may also be of use to other system leaders or organizations looking to improve quality improvement culture across their jurisdiction.
This past summer, Vanessa Rojas-Luengas, a 3rd year medical student at the University of Toronto joined the SREMI team as a research student, funded by the Comprehensive Research Experience for Medical Students (CREMS) Program. Under the supervision of Dr. Catherine Varner, NYGH Research Chair Dr. Katie Dainty and Shelley McLeod, and in collaboration with Bianca Seaton, Vanessa designed and carried out a phenomenologically-informed qualitative study exploring the experiences of women seeking care for early pregnancy loss in the emergency department (ED) and early pregnancy clinic (EPC) at Mount Sinai Hospital. A total of 30 women were interviewed; 14 were recruited during their ED visit, and 16 were recruited during their EPC visit. Our results demonstrate that women’s experiences and perceptions about their care drastically differed in the ED versus the EPC. Overall, many women felt a stronger sense of patient-centered support in the EPC compared to their experiences in the ED. Currently, these results are undergoing thematic analysis and 2 manuscripts will be drafted from this comprehensive study. These results will be presented at the national scientific meetings of the Canadian Association of Emergency Physicians and the Society of Obstetricians and Gynaecologists of Canada. Given the paucity of knowledge about the experiences of women seeking care for early pregnancy complications in EDs and EPCs in Toronto and the large body of literature suggesting these experiences can result in higher rates of psychological comorbidities, this data is vital to ensure women and their families are being well supported.