Effects of Stress in the Emergency Room Funded for Research on Simulation Training

Two clinicians rushing patient on hospital bed

The Agency for Healthcare Research and Quality (AHRQ) has awarded a $100,000 grant to Kathryn Kellogg, MD, MPH, to research the effects of stress in emergency medicine. The project, “Identifying Stress-Associated Factors to Develop Advanced Emergency Medicine Simulation,” focuses on the types and causes of stress that can affect patient outcomes in emergency situations.

Current research shows that stress not only has a negative impact on the well-being of patients and clinicians, but it also has a negative effect on decision-making, technical skills, and team interactions, which can lead to patient harm. The existing literature on stress focuses on data collected through surveys and interview data.

This research will identify specific stress-associated factors within an emergency department (ED) situation. Through a combination of physiologic responses and observational data, Dr. Kellogg and colleagues will produce a comprehensive list of stressors that can be correlated to physician physiologic response. Following the creation of this list of stressors, Dr. Kellogg and her team will conduct focus groups and interviews to validate the stressors.

This research will rely on an innovative method of measuring stress. "We have pilot tested an innovative method of measuring stress that utilizes unobtrusive sensors to capture physician physiological response," said Dr. Kellogg. This method allows for the combination of qualitative data with observational data to create a more complete picture of the environmental factors that may cause workplace stress in an ED.

Building on this research and MedStar’s work in simulation, the results from this study will be used in subsequent projects to develop preliminary scenarios for simulation training, with the intention to improve stress-induced reactions by ED physicians. In addition to supporting training for current clinicians, this work will develop "stress-management training tools and higher fidelity simulations to better prepare physicians-in-training for their clinical practice," said Dr. Kellogg.

Dr. Kellogg is an attending physician in Emergency Medicine at MedStar Washington Hospital Center, assistant professor at Georgetown University School of Medicine, and a clinical safety scientist at the National Center for Human Factors in Healthcare. She is also the recipient of MedStar Health’s New Investigator Award, supported by the annual associate giving campaign.