Answering clinical questions in the ED

Graber, Mark A.; Randles, Bradley D.; Ely, John W.; Monnahan, Jay

doi:10.1016/j.ajem.2007.03.031

« Previous Next »American Journal of Emergency Medicine
Volume 26, Issue 2 , Pages 144-147, February 2008

Answering clinical questions in the ED

Mark A. Graber, MD
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
- Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
- Corresponding author. Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA. Tel.: +1 319 356 2233.
- Mark A. Graber helped to design the study, analyze the data, and had primary responsibility for project oversight and writing the article.
Bradley D. Randles
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
- Bradley D. Randles helped to design the study, collect the data, and write the article.
John W. Ely, MD, MSPH
- Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
- John W. Ely helped to design the study, write the article, and helped with study oversight.
Jay Monnahan
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
- Jay Monnahan helped to collect the data and write the article.

Received 11 March 2007; received in revised form 23 March 2007; accepted 24 March 2007.

Abstract

Objectives

The objective of the study was to determine how many patient-related questions emergency medicine physicians have and how they answer them at the point of care.

Methods

We conducted an observational study of 26 physicians at 2 institutions. All physicians were followed for at least 2 shifts. The number and type of questions were recorded. The percentage answered, resources used, and barriers to answering questions were also recorded.

Results

Physicians had 235 questions or approximately 5 questions per 8-hour shift . They attempted to answer 81% of them and were successful 87% of the time. The 2 most commonly used information sources were drug information resources (Personal digital assistant [PDA], pocket pharmacopeia [37% of the time]) followed by electronic resources (Google, UpToDate [29% of the time]). The most common reason for not pursuing a question was lack of time and distractions or interruptions, followed by a belief that an answer would not be found. When an answer was not found to a pursued question, non–emergency department physicians were the most common resource consulted (28%).

Conclusions

Emergency department physicians in this study pursued and found answers for most questions posed at the point of care. Rapid access to electronic resources and drug-prescribing references were critical for answering questions at the point of care.