Amid COVID the pandemic, more than 70 percent of emergency physicians say they’ve experienced the sort of fatigue which can lead to exhaustion and stress.
Thomas Jefferson University and the University of the Arts have teamed up for a creative approach to studying physician burnout in the emergency room, at a time when those insights are needed most.
Through a cross-disciplinary project—made possible by a grant from the Emergency Medicine Foundation and HKS Architects—Jefferson’s Health Design Lab and Emergency MedineDepartment will partner with the University of the Arts’ new Center for Immersive Media (CIM). The team will use virtual-reality modelling the aim of identifying and improving physical conditions that contribute to stress, fatigue and poor job satisfaction.
This news comes at a time when emergency departments across the country are dealing with a spike in COVID-19 patients, and a vast majority of emergency-room physicians and staff have reported some level of burnout.
In the current pandemic, the impact of poor ER design is felt even more by frontline workers. –Dr. J. Matthew Fields
Officials at both universities are excited about what could come from the collaboration, which will use high-fidelity virtual reality modelling, conducted at the CIM, to analyze the environmental factors of the Emergency Medicine Department at Thomas Jefferson University.
“Now more than ever, we must understand and redesign the human experience of frontline emergency rooms,” says Stephen K. Klasko, MD, MBA, President of Thomas Jefferson University and CEO of Jefferson Health. “It’s a brilliant opportunity to provide much-needed relief and benefit emergency staff and their patients.”
David Yager, president and CEO of University of the Arts, lauds the partnership involved in a “groundbreaking and timely study.”
“It is this type of cross-disciplinary thinking and creative collaboration that embraces the essential role of the arts that I believe is going to be critical to our success as society as we emerge from a global pandemic,” Yager says, noting that this and other joint projects between the schools “demonstrate the innovative power that’s at the intersection of the arts and sciences.”
Leading the effort is Dr. J. Matthew Fields—principal physician investigator and associate professor of emergency medicine at Thomas Jefferson University—and Alan Price, director of the CIM, a 5,600-square-foot facility devoted to emerging and new technologies. The multidisciplinary team also includes architects of KieranTimberlake Architecture and health-design psychologists from Jefferson.
“If you have ever been in a busy ER, or seen one on TV, it’s not surprising people working in them frequently burnout. There can be high stress, chaos, noise, crowded halls, poor lighting and a lack of windows or respite areas,” says Dr. Fields. “In the current pandemic, the impact of poor ER design is felt even more by frontline workers.”
Dr. Fields notes that while efforts have been made in the past to reduce physician burnout, this collaboration marks the first time that attempts have been made to change the environment itself to help do so. That’s what makes the collaboration to use high-fidelity virtual modelling of the ER space so important.
It is critically important to teach our students the human-centered skills that will allow them to find solutions to the world’s most pressing problems. –Dr. Mark Tykocinski
Environmental factors such as lighting, presence of windows, access to nature, aesthetics and imagery, ventilation, space, circulation and wayfinding, noise and ergonomics have been proven to correlate with levels of stress, fatigue and low job satisfaction in other healthcare settings.
The goal is pinpointing areas that create the most stress and then applying design-thinking principles to reimagine and redesign them, Dr. Fields adds.
“The sensory-rich experience of virtual reality has the ability to illicit increased verbal, physical, and emotional response to what physicians actually experience in emergency settings,” says Price. “Our simulation will allow doctors to ‘step out’ of the moment, and hopefully provide detail that would otherwise be difficult or impossible in the actual environment.”
Still, these factors have not been explicitly examined within emergency room settings—in part due to the complexity of studying an active and highly-trafficked emergency setting. Leveraging virtual reality will help the team study, and later manipulate, the emergency setting’s environmental factors without disrupting the life-saving activities of a currently operating academic emergency department.
“It is critically important to teach our students the human-centered skills that will allow them to find solutions to the world’s most pressing problems,” says Dr. Mark Tykocinski, Provost of Thomas Jefferson University and Anthony F. & Gertrude M. DePalma Dean of the Sidney Kimmel Medical College.
The grant was made possible by HKS—a recognized leader in healthcare design—and the Emergency Medicine Foundation, a nonprofit founded by the American College of Emergency Physicians (ACEP).
Design can help mitigate stressful conditions and support staff well-being, which is critically important. — Jason Schroer
For the past several years, ACEP has placed a special emphasis on the issue of physician burnout due to the extremely stressful work environment, unique patient populations, and 24/7 operations of emergency departments.
These factors have been exacerbated due to COVID-19. According to a recent poll from ACEP, 72 percent of emergency physicians report experiencing greater professional burnout since the pandemic began.
“Staff burnout is a significant issue across the healthcare system. Design can help mitigate stressful conditions and support staff well-being, which is critically important,” says Jason Schroer, AIA, principal and health practice leader at HKS. “We are honored to partner with EMF to research design’s potential to ameliorate caregiver burnout.”