Can J Emerg Med
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Emergency physicians (EPs) are uniquely positioned to act as health advocates for individual patients, emergency department (ED) patient populations and the Canadian public. However, most ED practice environments do not encourage health advocacy, and staff EPs often do not feel adequately prepared to address many health-determinant issues. ⋯ At the University of Toronto, we have developed a new curriculum using evidence-based ED initiatives, examples of Canadian EP advocacy, and a description of organizations involved in advocacy, and we have incorporated several principles of adult learning to increase learner investment, maximize relevancy for EPs and optimize retention into practice. Residents believe the curriculum is highly relevant, allowing them to recognize advocacy opportunities in their own practices.
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Triage reliability studies typically use hypothetical scenarios and weighted kappa scores where agreement within one level is considered satisfactory. But if triage category is used to help define ED case-mix groups for comparative or benchmarking processes, agreement on exact triage level and major system involved is important. Our hypothesis was that a computerized menu that links presenting complaints to preferred triage levels (PC-linked triage) would provide high triage reliability. ⋯ PC-linked triage has high inter-rater reliability in a real-time clinical setting. PC-linked triage may be useful as one factor in defining case-mix groups for benchmarking and comparative purposes.
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Reviews of the medical literature have always been an important resource for physicians. Increasingly, qualitative and quantitative "systematic reviews" have replaced the traditional "narrative review" as a means of capturing and summarizing current evidence on a topic or, when possible, answering a specific clinical question. ⋯ To facilitate readability, examples from the emergency medicine literature have been included for illustrative purposes and technical details have been kept to a minimum. The references, however, are comprehensive and provide a resource for readers seeking further information.