James Stempien

University of Saskatchewan | U of S · Department of Emergency Medicine

Introduction Canadian patients presenting to the emergency department (ED) typically undergo a triage process where they are assessed by a specially trained nurse and assigned a Canadian Triage and Acuity Scale (CTAS) score, indicating their level of acuity and urgency of assessment. We sought to assess the ability of patients to self-triage themse...

The Canadian Association of Emergency Physicians’ (CAEP) Global Emergency Medicine committee presents a four-part series that builds upon the Academic Symposium recommendations from the CAEP 2018 meeting (Collier et al. in CJEM 21(5):600–606, 2019). This series presents best practices and offers practical tools for the development and practice of G...

In 2018, the Canadian Association of Emergency Physicians (CAEP) academic symposium included developing recommendations on supporting global emergency medicine (EM) in Canadian departments and divisions. Members of CAEP’s Global EM committee created a four-part series to be published in CJEM that would build upon the symposium recommendations. The...

The significance of physician leadership to help transform the healthcare system has been increasingly discussed. This study looked at the qualities of emergency medicine (EM) physicians that support or inhibit their work as healthcare leaders. Through an iterative process of semi-structured interviews and then focus groups, we examined why EM phys...

INTRODUCTION Canadian patients presenting to the emergency department (ED) typically undergo a triage process where they are assessed by a specially trained nurse and assigned a Canadian Triage and Acuity Scale (CTAS) score, indicating their level of acuity and urgency of assessment. We sought to assess the ability of patients to self-triage themse...

Objective Communication during consultations between referring and consultant physicians is often cited as a source of adverse events, medical error and professional incivility. While existing literature focuses on the role of referring physicians, few studies acknowledge the role of consultant physicians in enhancing communication during consultat...

We detail a case study using a participatory modeling approach in the development and use of discrete-event simulations to identify intervention strategies aimed at reducing emergency department (ED) wait times in a Canadian health policy setting. A four-stage participatory modeling approach specifically adapted to the local policy environment was...

Objectives: Lengthy emergency department (ED) wait times caused by hospital access block is a growing concern for the Canadian health care system. Our objective was to quantify the impact of alternate-level-of-care on hospital access block and evaluate the likely effects of multiple interventions on ED wait times. Methods: Discrete-event simulat...

Background: Health literacy is increasingly recognized as a major determinant of health; however, our insights into the health literacy strengths and needs of adults living with serious or persistent mental illness remain limited by a notable lack of research in this area. Improving our understanding is important because people in this group are e...

Responding to a provincial government decision to develop two Urgent Care Centres (UCCs) in Saskatchewan, we undertook a rapid review of published literature with the objective of determining best practices for their creation and functioning. Two English-limited PubMed database searches combining "after-hours care," "ambulatory care," "emergency me...

Context Pain is a primary reason individuals attend an Emergency Department (ED), and its management is a concern. Objectives Change in symptoms and physiologic variables at 3 time points pre-post a ten-minute St. John Ambulance therapy dog team visit compared to no visit in ED patients who experienced pain. Design, setting and participants Using...

Introduction: The purpose of this study was to identify, through self-assessment, how comfortable rural emergency medicine (EM) physicians are in treating critically ill trauma patients, the resources available to treat such patients and their comfort with performing trauma procedures. Methods: An anonymous self-assessment survey was e-mailed to...

Objectives To characterize unidentified patients presenting to a single, urban emergency department (ED) in Canada. We report their demographics, ED course, post-ED discharge outcomes, and mode of identification. Methods We performed a retrospective chart review using descriptive analyses to assess unidentified patients admitted to Royal University...

Background and objective Emergency departments (EDs) often find the number of arriving patients exceeding their capacity and find it difficult to triage them in a timely manner. The potential risk to the safety of patients awaiting assessment by a triage professional has led some hospitals to consider implementing patient self-triage, such as using...

Introduction: Tobacco smoking is a priority public health concern, and a leading cause of death and disability globally. While the daily smoking prevalence in Canada is approximately 9.7%, the proportion of smokers among emergency department (ED) patients has been found to be significantly higher. The purpose of this survey study was to determine...

Introduction: The purpose of this study was to identify, through self-assessment, how comfortable rural emergency medicine (EM) practitioners are in treating critically ill trauma patients, the resources available to treat such patients and their comfort with performing trauma procedures. Our goal is to enhance rural trauma care by identifying obst...

Introduction: Patients who are not identified upon presentation to the emergency department (ED), commonly referred to as John or Jane Does (JDs), are a vulnerable population due to the sequelae associated with this lack of patient information. To date, there has been minimal research describing JDs. We aimed to characterize the JD population and d...

Introduction: Cigarette smoking is a leading global cause of morbidity and mortality. Multiple studies internationally have established that cigarette smoking prevalence is higher in emergency department (ED) patients than their respective communities. Previously, we demonstrated the smoking prevalence among Saskatoon ED patients (19.6%) is signifi...

To date there have been no studies examining whether patients want emergency department (ED) therapy dog programs. This patient-oriented study examined the opinions of patients about whether they would want to be visited by a therapy dog in the Royal University Hospital ED. Cross-sectional survey data were collected over a six week period from a co...

Objective HealthLine is Saskatchewan's provincial 24-hour health information and support telephone line. A proportion of HealthLine's callers are referred to the emergency department (ED) for further assessment. The purpose of this study was to gain insight into the appropriateness of these referrals and assess whether they increased the burden on...

Introduction Transitions of care for elderly patients in long term care (LTC) to the emergency department (ED) is fraught with communication challenges. Information preferred during these transitions has not been agreed upon. We sought to understand our local handover culture and identify what information is preferred in the transitions of care of...

Introduction : Patient satisfaction is an essential component of effective delivery of quality care in the emergency department (ED). Frequent reflection on current practices is required to detect areas in need of improvement. The Ontario Hospital Association (OHA) outlined five ‘Leading Practices’ (LPs) targeted to increase patient satisfaction in...

Introduction : Tobacco smoking is a priority public health concern, and a leading cause of death and disability globally. While the smoking prevalence in Canada is approximately 13-18%, the proportion of smokers among emergency department (ED) patients has been found to be significantly higher. This disparity primes the emergency department as a cr...

Introduction : When presenting to the Emergency Department (ED), the care of elderly patients residing in Long Term Care (LTC) can be complicated by threats to patient safety created by ineffective transitions of care. Though standardized inpatient handover tools exist, there has yet to be a universal tool adopted for transfers to the ED. In this s...

The quality of patient healthcare is a growing concern in Canada’s hospital emergency departments (ED) due to increasing wait times and associated adverse outcomes. A developing body of literature indicates that therapy dogs can positively impact the patient experience. In 2016, members of our team partnered with the Royal University Hospital (RUH)...

Background: Emergency departments (ED) serve a critical role in addressing the health care needs of older adults, although organizational and provider characteristics can result in unintended negative outcomes for this population, such as emotional harm. This study aimed to describe the patient experience of older adults in the ED and generate reco...

CLINICIAN’S CAPSULE What is known about the topic? Taking photographs and educational videos are common in emergency departments (EDs), but little research exists about patients recording their own procedures. What did this study ask? What are patients’ reasons for video recording in the ED and the views of patients and clinicians toward this pract...

An open letter to the emergency medicine community - Volume 20 Supplement - James Stempien

CLINICIAN’S CAPSULE What is known about the topic? While EDs serve a critical role in the care of older adults, about 25% of visits made by older adults are classified as “non-urgent”. What did this study ask? What are older adults’ reasons for seeking non-urgent care in EDs? What did this study find? Comprehensiveness and convenience of diagnostic...

Introduction: As experienced in Emergency Departments (EDs) across Canada, Saskatoon EDs have a percentage of patients that leave before being assessed by a physician. This Left Without Being Seen (LWBS) group is well documented and we follow the numbers closely as a marker of quality, what happens after they leave is not well documented. In Saskat...

CLINICIAN’S CAPSULE What is known about the topic? There are concerns regarding unequal treatment towards First Nations people when engaged with health care services. What did this study ask? Whether quantitative differences in care exist between First Nations and non-First Nations patients in the ED. What did this study find? First Nations present...

Introduction: Animal-assisted interventions (AAI) have been applied in numerous clinical settings to help reduce pain, stress, and anxiety. This qualitative study sets out to evaluate the St. John Ambulance Therapy Dog program in the emergency department of the Royal University Hospital. Methods: An observer identified patients interested in visiti...

Introduction: The process of triage is used to prioritize the care of patients arriving in the emergency department (ED). To our knowledge, self-triage has not been previously studied in the general emergency department (ED) setting. In an attempt to test the feasibility of implementing this in the ED, we sought to assess the ability of ED patients...

Study objective: Open educational resources such as blogs are increasingly used for medical education. Gestalt is generally the evaluation method used for these resources; however, little information has been published on it. We aim to evaluate the reliability of gestalt in the assessment of emergency medicine blogs. Methods: We identified 60 En...

A determination of emergency department pre-triage times in patients not arriving by ambulance compared to widely used guideline recommendations – CORRIGENDUM - M. Betz, J. Stempien, S. Trivedi, R. Bryce

Objectives Emergency department (ED) lengths of stay are measured from the time of patient registration or triage. The time that patients wait in line prior to registration and triage has not been well described. We sought to characterize pre-triage wait times and compare them to recommended physician response times, as per the Canadian Triage and...

Studies have shown that First Nations patients have poorer health outcomes than non-First Nations patients. This has raised concerns that they receive unequal treatment from the health care system in general and the Emergency Department (ED) in particular. We sought to determine if there was such a difference and what it was so that it could be cor...

Objectives: A panel of emergency medicine (EM) leaders endeavoured to define the key elements of leadership and its models, as well as to formulate consensus recommendations to build and strengthen academic leadership in the Canadian EM community in the areas of mentorship, education, and resources. Methods: The expert panel comprised EM leaders...

Emergency Department (ED) triage systems have become increasingly comprehensive over time, requiring ever more resources such as nursing time and computer support. There are very few studies that have looked at whether this increased complexity results in improved performance. This study looked at one aspect of performance, comparing reliability of...

Objectives: To systematically evaluate the accuracy of text descriptions and labeling of radiologic images published in the Canadian Journal of Emergency Medicine (CJEM). Error detection by radiologists and emergency physicians and the clinical significance and educational value of these errors were assessed. Errors were also correlated with radio...

The American Heart Association (AHA) revises the Advanced Cardiac Life Support (ACLS) course approximately every 5 years, citing the scientific literature for any changes to content and management recommendations. With ACLS 2005, the AHA also revised the methods used to teach course content. The AHA cited no evidence in making these changes. The AC...