“I never hear what happens, even if they die”: a survey of emergency physicians about outcome feedback

Abstract

ABSTRACT Objective: Emergency physicians (EPs) rarely find out what happens to patients after the patients leave their care, a process we call “outcome feedback.” Some suggest this hinders the practice of emergency medicine (EM); however, evidence is lacking. We sought to evaluate EPs' perception of the current and potential role of outcome feedback in EM. Methods: We surveyed practising French- and English-speaking EPs from emergency departments within 100 km of Ottawa, Ont., in the provinces of Ontario and Quebec. The main outcomes included the prevalence, role and effect of outcome feedback. Results: Of the 297 physicians surveyed, 231 (77.8%) responded. The sample contained good representation of language groups, practice settings, sexes and age groups. All participants indicated that knowing outcomes is “essential” (62.6%) or “beneficial” (37.4%) to gaining experience in EM. Participants reported currently receiving passive outcome feedback in 10.0% of all cases, and seeking out (active) outcome feedback in 7.5% of all cases. The great majority of participants (97.3%) stated that they would like to receive more outcome feedback and believed that this would improve diagnostic accuracy (97.3%), clinical efficiency (85.5%), treatment outcomes (95.6%) and job satisfaction (95.1%). When asked to indicate “any possible negative effects that might arise from increased outcome feedback,” 62.1% indicated none. However, 17.9% hypothesized negative emotional effects and 11.5% suggested increased time requirements. Conclusion: The overwhelming majority of EPs receive very little outcome feedback. Most would like more outcome feedback and believe it would improve the practice of EM.