ArticleAEM education and training2020
Defining "Swarming" as a New Model to Optimize Efficiency and Education in an Academic Emergency Department.
Article in AEM education and training, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Trial
- Sepsis Diagnostic Excellence: Development and Validation of a Theoretical Framework for Conceptualizing Accurate, Timely Sepsis Diagnosis.Critical care explorations · 2026Observational
- The use of biomarkers testing in Emergency Department.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- Frontline Providers' and Patients' Perspectives on Improving Diagnostic Safety in the Emergency Department: A Qualitative Study.Joint Commission journal on quality and patient safety · 2024Article
- Using 360-degree video for teaching emergency medicine during and beyond the COVID-19 pandemic.Annals of medicine · 2021Article
- Teacher as scribe: A novel way to augment direct observation in the emergency department.AEM education and training · 2021Article
- Types and Timing of Teaching During Clinical Shifts in an Academic Emergency Department.The western journal of emergency medicine · 2021Article
- The Parallel Encounter: An Alternative to the Traditional Serial Trainee-Attending Patient Evaluation Model.AEM education and training · 2020Article
- Defining "Swarming" as a New Model to Optimize Efficiency and Education in an Academic Emergency Department.AEM education and training · 2020Article
- Improving Wait Times for Children with Caregivers with Limited English Proficiency in the Emergency Department.Pediatric quality & safetyArticle
- Under-triage: A New Trigger to Drive Quality Improvement in the Emergency Department.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcademic emergency medicine is a constant balance between efficiency and education. We developed a new model called swarming, where the bedside nurse, resident, and attending/fellow simultaneously evaluate the patient, including initial vital signs, bedside triage, focused history and physical examination, and discussion of the treatment plan, thus creating a shared mental model.
objectivesTo combine perceptions from trainee physicians, supervising physicians, nurses, and families with in vivo measurements of emergency department swarms to better conceptualize the swarming model.
methodsThis mixed methods study was conducted using a convergent design. Qualitative data from focus groups with nurses, residents, and attendings/fellows were analyzed using directed content analysis. Swarming encounters were observed in real time; durations of key aspects and family satisfaction scores were analyzed using descriptive statistics. The qualitative and quantitative findings were integrated a posteriori.
resultsFrom the focus group data, 54 unique codes were identified, which were grouped together into five larger themes. From 39 swarms, mean (±SD) time (minutes) spent in patient rooms: nurses = 6.8 (±3.0), residents = 10.4 (±4.1), and attendings/fellows = 9.4 (±4.3). Electronic documentation was included in 67% of swarms, and 39% included orders initiated at the bedside. Mean (±SD) family satisfaction was 4.8 (±0.7; Likert scale 1-5).
conclusionsSwarming is currently implemented with significant variability but results in high provider and family satisfaction. There is also consensus among physicians that swarming improves trainee education in the emergency setting. The benefits and barriers to swarming are underscored by the unpredictable nature of the ED and the observed variability in implementation. Our findings provide a critical foundation for our efforts to refine, standardize, and appraise our swarming model.
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