Study Proves Dedicated ED Staff Not Distracted by Facebook

Recently, the Journal of Internet Medical Research published an article claiming that ED staff spent 12 minutes out of every hour surfing on Facebook (http://www.jmir.org/2013/5/e94).  Worse, they found that the ED staff use of Facebook increased from 7 p.m. to 7 a.m. when the ED was at its busiest!  They concluded that the ED staff spent too much time on Facebook when they should have been providing patient care.  This incredible result was picked up fairly widely by the lay press as another example of the many failures of our healthcare system.

However, the conclusion is shockingly misleading because the data actually shows that their dedicated ED staff actually spent much less than a minute per person hour on Facebook.

If you read the article carefully, you see that the 12 minutes per hour on Facebook is not per person.  It’s the cumulative time spent on Facebook each hour added up across every member of the staff.  The authors did not report their staffing levels to enable calculation of the per person Facebook usage, but this appears to be a huge ED because the authors report they have 68 workstations.  If they had 20-30 people working in that ED, that’s just 30 seconds or less of Facebook time per person per hour.  With 68 workstations, the ED staff working during any one shift might even be larger, bringing the average per person per hour Facebook time down to just a few seconds.

The authors made no attempt to determine whether those using Facebook were on break, or whether they had arrived early or stayed late and were checking Facebook during their own time.  They made no attempt to determine whether those using Facebook included the many non-ED staff (consultants, admitting residents, therapists, x-ray techs, etc…) that may spend time in the ED.  It is certainly possible – even probable – that the few seconds of Facebook time per person per hour were incurred largely or entirely during break periods, off-work hours, and/or by non-ED staff.

Finally, the EDWIN score the authors used to assess ED workload is actually a measure of ED crowding, not ED staff “busy-ness.”  At 3 a.m. most EDs have reduced staffing and a large number of patients sleeping in ED beds awaiting an inpatient bed.  In those cases the EDWIN score will be high even when there is little or no work to do. It is not surprising nor even concerning that Facebook use was higher during the overnight shift – especially since that “increased use” was probably less than a minute per user per hour.

ED staff are top-notch, hard-working, highly skilled, and tremendously dedicated workers. They literally put their lives on the line every day, all day, on the front lines of care. This study’s data actually demonstrates how truly dedicated ED staff members really are. In other words, the article’s own data demonstrates the opposite of its conclusion.

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