Impact of Attending Physicians' Comments on Residents' Workloads in the Emergency Department: Results from Two J(^o^)PAN Randomized Controlled Trials

• Published in: PloS one 2016-12, Vol.11 (12), p.e0167480-e0167480
• Main Authors: Kuriyama, Akira, Umakoshi, Noriyuki, Fujinaga, Jun, Kaihara, Toshie, Urushidani, Seigo, Kuninaga, Naoki, Ichikawa, Motohiro, Ienaga, Shinichiro, Sasaki, Akira, Ikegami, Tetsunori
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Clinical trials; Emergency medical care; Emergency medical services; Emergency Service, Hospital - statistics & numerical data; Humans; Internship and Residency - statistics & numerical data; Intervention; Japan; Medical personnel; Medical research; Medicine and Health Sciences; Patient Care - statistics & numerical data; Patient safety; Patient Transfer - statistics & numerical data; Patients; People and Places; Physical Sciences; Physicians; Randomization; Research and Analysis Methods; Single-Blind Method; Social Sciences; Studies; Surveys and Questionnaires; Tertiary Care Centers; Working conditions; Workload; Workload - psychology; Workload - statistics & numerical data
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0167480

To examine whether peppy comments from attending physicians increased the workload of residents working in the emergency department (ED). We conducted two parallel-group, assessor-blinded, randomized trials at the ED in a tertiary care hospital in western Japan. Twenty-five residents who examined either ambulatory (J(^o^)PAN-1 Trial) or transferred patients (J(^o^)PAN-2 Trial) in the ED on weekdays. Participants were randomly assigned to groups that either received a peppy message such as "Hope you have a quiet day!" (intervention group) or did not (control group) from the attending physicians. Both trials were conducted from June 2014 through March 2015. For each trial, residents rated the number of patients examined during and the busyness and difficulty of their shifts on a 5-point Likert scale. A total of 169 randomizations (intervention group, 81; control group, 88) were performed for the J(^o^)PAN-1 Trial, and 178 (intervention group, 85; control group, 93) for the J(^o^)PAN-2 Trial. In the J(^o^)PAN-1 trial, no differences were observed in the number of ambulatory patients examined during their shifts (5.5 and 5.7, respectively, p = 0.48), the busyness of their shifts (2.8 vs 2.8; p = 0.58), or the difficulty of their shifts (3.1 vs 3.1, p = 0.94). However, in the J(^o^)PAN-2 trial, although busyness (2.8 vs 2.7; p = 0.40) and difficulty (3.1 vs 3.2; p = 0.75) were similar between groups, the intervention group examined more transferred patients than the control group (4.4 vs 3.9; p = 0.01). Peppy comments from attending physicians had a minimal jinxing effect on the workload of residents working in the ED. University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), UMIN000017193 and UMIN000017194.