Sofia Sagaidak

Supervisor: Rhonda Rosychuk

Project: Emergency department crowding and patient outcomes for Alberta children presenting for asthma

Degree program:

Medicine & Dentistry-Pediatrics

Lay abstract:

Emergency department (ED) crowding is a major problem in the Canadian healthcare system and has become one of the most important issues in healthcare delivery. ED crowding has been linked to delays of time-sensitive interventions (e.g., administration of pain medications, treatment of stroke and heart attacks), poor patient outcomes, patients leaving without completing care, patient and staff dissatisfaction and increased healthcare spending. More importantly, ED crowding has been shown to increase the risk of patient deaths and decrease quality of care, especially when hospitals have high occupancy and physician assessment is delayed.  Obstructive lung diseases such as asthma are ambulatory-care sensitive conditions that require prompt and appropriate care in the ED. In Canada, we have little evidence on how ED crowding impacts quality of care and health outcomes in patients with these conditions. This project will use administrative health data to analyze all ED visits for asthma made by children aged 2 to 17 in 18 high-volume EDs in Alberta from 2002 to 2015. Measures of ED crowding (wait time, time to physician assessment and time in ED) will be calculated for each ED. For children with asthma who visit an ED, we will examine the impact of measured ED crowding on their outcomes including time in the ED, admission to hospital and time spent there, physician follow-up and return to ED. This study will be a novel examination of the impact of ED crowding on patient outcomes in a respiratory condition that carries a significant burden for the health system, patients and society. Results of this study are important for patients, health providers and health administrators to further understand the negative consequences of ED crowding on health outcomes. Our findings can encourage patient-oriented interventions aimed at reducing the impact of ED crowding in for children with asthma.

What motivated you to participate in this research?

My previous research involved basic science laboratory work in the fields of microbiology and nutrition. I wanted to broaden my research abilities by trying something very different. This project provided the opportunity to learn how to analyze medical data using the programming language of R, a statistical computing and graphics software widely used for data analysis. Furthermore, a major interest of mine is improving patient care. I believe this project is very important because asthma is one of the most common reasons for children to present to an emergency department. If we are to find that ED crowding compromises patient care and health outcomes in Albertan children, this information will help encourage interventions to reduce these negative effects.

What are your career aspirations?

I’m entering my second year of medical school at the University of Alberta in the fall. I became interested in emergency medicine after shadowing an emergency physician during my first year of studies. I find the variability and fast paced environment both challenging and exciting. Although I’m still unsure of the type of medicine I will pursue, I’m strongly considering emergency medicine and pediatrics. I hope to also conduct research in addition to clinical practice.

How has this studentship helped you toward those aspirations?

The statistical and programming knowledge I’ve acquired this summer can be applied to many future projects involved with analyzing healthcare data and determining areas that need improvements and interventions. I also recognize the importance of correctness and completeness of administrative data for conducting research, as there have been many occurrences of missing information and inconsistencies, which are timely to sort through and can result in the data not being used. I will be very mindful of this as a physician. Furthermore, I gained skills in searching and understanding scientific literature, which is very important for a career practicing science-based medicine. In addition, through interactions with master's level statisticians and statistical trainees, I’ve seen the challenges and opportunities of interdisciplinary research endeavours. Overall, I’m extremely grateful for this opportunity and the support provided by the Stollery Children's Hospital Foundation through WCHRI!