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. 2019 Aug 8;7(3):e13993.
doi: 10.2196/13993.

Development and Evaluation of a Virtual Research Environment to Improve Quality of Care in Overcrowded Emergency Departments: Observational Study

Charles-Henri Houze-Cerfon  1   2   3 , Christine Vaissié  4 , Laurent Gout  1 , Bruno Bastiani  3 , Sandrine Charpentier  1 , Dominique Lauque  1
Affiliations

Development and Evaluation of a Virtual Research Environment to Improve Quality of Care in Overcrowded Emergency Departments: Observational Study

Charles-Henri Houze-Cerfon et al. JMIR Serious Games. .

Abstract

Background: Despite a wide range of literature on emergency department (ED) overcrowding, scientific knowledge on emergency physicians' cognitive processes coping with overcrowding is limited.

Objective: This study aimed to develop and evaluate a virtual research environment that will allow us to study the effect of physicians' strategies and behaviors on quality of care in the context of ED overcrowding.

Methods: A simulation-based observational study was conducted over two stages: the development of a simulation model and its evaluation. A research environment in emergency medicine combining virtual reality and simulated patients was designed and developed. Afterwards, 12 emergency physicians took part in simulation scenarios and had to manage 13 patients during a 2-hour period. The study outcome was the authenticity of the environment through realism, consistency, and mastering. The realism was the resemblance perceived by the participants between virtual and real ED. The consistency of the scenario and the participants' mastering of the environment was expected for 90% (12/13) of the participants.

Results: The virtual ED was considered realistic with no significant difference from the real world with respect to facilities and resources, except for the length of time of procedures that was perceived to be shorter. A total of 100% (13/13) of participants deemed that patient information, decision making, and managing patient flow were similar to real clinical practice. The virtual environment was well-mastered by all participants over the course of the scenarios.

Conclusions: The new simulation tool, Virtual Research Environment in Emergency Medicine, has been successfully designed and developed. It has been assessed as perfectly authentic by emergency physicians compared with real EDs and thus offers another way to study human factors, quality of care, and patient safety in the context of ED overcrowding.

Keywords: emergency medicine; interprofessional relations; virtual reality.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Design, development, and assessment of Virtual Research Environment in Emergency Medicine.
See this image and copyright information in PMC

References

    1. Sun BC, Hsia RY, Weiss RE, Zingmond D, Liang LJ, Han W, McCreath H, Asch SM. Effect of emergency department crowding on outcomes of admitted patients. Ann Emerg Med. 2013 Jun;61(6):605–11.e6. doi: 10.1016/j.annemergmed.2012.10.026. http://europepmc.org/abstract/MED/23218508 - DOI - PMC - PubMed
    1. Chiu IM, Lin YR, Syue YJ, Kung CT, Wu KH, Li CJ. The influence of crowding on clinical practice in the emergency department. Am J Emerg Med. 2018 Jan;36(1):56–60. doi: 10.1016/j.ajem.2017.07.011. - DOI - PubMed
    1. Ratwani RM, Fong A, Puthumana JS, Hettinger AZ. Emergency physician use of cognitive strategies to manage interruptions. Ann Emerg Med. 2017 Nov;70(5):683–7. doi: 10.1016/j.annemergmed.2017.04.036. - DOI - PubMed
    1. Yarmohammadian MH, Rezaei F, Haghshenas A, Tavakoli N. Overcrowding in emergency departments: a review of strategies to decrease future challenges. J Res Med Sci. 2017;22:23. doi: 10.4103/1735-1995.200277. http://www.jmsjournal.net/article.asp?issn=1735-1995;year=2017;volume=22... - DOI - PMC - PubMed
    1. Wang H, Ojha RP, Robinson RD, Jackson BE, Shaikh SA, Cowden CD, Shyamanand R, Leuck J, Schrader CD, Zenarosa NR. Optimal measurement interval for emergency department crowding estimation tools. Ann Emerg Med. 2017 Nov;70(5):632–9.e4. doi: 10.1016/j.annemergmed.2017.04.012. - DOI - PubMed