Improvements of the working conditions for physicians and patient safety in emergency departments

Background: A high staff turn-over and crowding are common problems in emergency departments (EDs). These problems coexist with a gradual decrease in hospital beds per capita. Many emergency physicians report burnout and plan to resign. Therefore, mostly inexperienced physicians, early in their career, are responsible for front-line emergency care. Methods: Literature review and analysis of work environment in EDs. Based on this, structural and individual measures were proposed in order to optimize the work environment for physicians. Results: Working conditions in the ED could be improved through modified back-up, checklists/algorithms, increased number of hospital beds, and optimal use of available beds, and a revision of the current shift organization. Conclusions: We hope that this analysis will prompt a debate that may lead to improvements in work satisfaction, resource utilization and quality of care.