SAEM Pulse September-October 2021

Page 28


The New Frontier in Academic Emergency Medicine: A Tale of Two EDs SAEM PULSE | SEPTEMBER-OCTOBER 2021

By Nicholas Stark, MD; William Baker, MD; Zaid Altawil, MD; Stephanie Stapleton, MD; and Christopher Peabody, MD, MPH on behalf of SAEM’s ED Administration and Clinical Operations Committee


Adjusting to constant change and thriving amid limited resources is the bedrock of emergency medicine (EM). While EM physicians are experts in making rapid decisions and adjusting them based on new information in the clinical environment, emergency department (ED) systems are often much less agile. The unprecedented challenges presented by the COVID-19 pandemic highlighted weaknesses in these existing systems, whether in the realm of disrupted supply chains for personal protective equipment (PPE), weakened physical infrastructure, or interrupted clinical communication platforms. These challenges created a profound sense of urgency that

catalyzed a new wave of innovation across the field that continues to grow. This article highlights innovations developed by two large academic EDs in response to the COVID-19 pandemic and explores the potential for incorporating innovation into the academic EM environment. Innovation (i.e., the creation, development and implementation of a new product or process with the aim of improving a system or creating new value) has become increasingly vital in health care. Innovation within EM — especially at large, academic centers — is often challenged by complex problems involving multiple systems and stakeholders. Work toward change

is traditionally focused on discovering convergent solutions for these oftendivergent problems, where flexible, multi-element solutions that can quickly evolve may be both timelier and have greater impact. Two academic EDs — Boston University affiliated Boston Medical Center (BMC) and the University of California San Francisco affiliated S.F. General Hospital (SFGH) — worked to transform weaknesses exposed by the COVID-19 pandemic into meaningful opportunities for rapid-cycle innovation in large academic settings. By utilizing key principles of engaging stakeholders, design thinking, rapidcycle optimization, and working closely

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