​​​​I talk to a lot of people in this job. Shared stories in our field of practice bring both highs and lows (more about that later). The highs include the feeling of connecting, sharing ideas and stories, sharing problems. The role of IFEM as a global federation of national and regional societies, is to connect and to help. We are growing our administrative team in response to your feedback. I will introduce you to some new faces in coming newsletters.

Look out for some exciting developments coming up. I want to thank everyone who throws their energy into Team IFEM, unpaid, and on top of an exhausting job (for most of us). As well as the contributors I mention below, there are many others, all working in teams and on other projects.

Our new Board of Directors is hard at work. We are improving the orientation / induction for roles within IFEM, led by Dr Cherri Hobgood. We are really looking forward to our new IFEM mentorship program led by Dr Mulinda Nyirenda and Dr Maaret Castren is developing an IFEM Equality and Diversity Policy. Dr John Bonning is helping grow IFEM’s outward reach alongside IFEM’s wonderful Miranda Smith (Communication Manager).

IFEM has a big role in global emergency care education. Dr Connie Le Blanc, Chair of the CPD Committee, is looking at course accreditation (credits for our own learning events and IFEM endorsement of external courses). Dr Janet Lin, Dr Elif Cakal and others are leading on further developing our online education program. Please see the IFEM website for details of our upcoming “Mental Health Around The World” and “Major Trauma Around The World” events. Our academic activities and ICEM conferences are overseen by Dr Elizabeth DeVos, who is doing a great job in this new Director role for IFEM.

Dr Srinath Kumar our Treasurer, along with past Presidents Prof Sally McCarthy and Prof Jim Ducharme are keeping our finances on solid ground while seeking expertise and ideas for future growth so that we can provide better services to you while avoiding big increases in membership fees for our member societies (over and above global inflation, which of course is a current problem).

Our six Board Regional Representatives are busy reaching out to societies in their territories of responsibility. IFEM will always do what it can to help member nations and regions and of course, we welcome applications for new members.

Working alongside the World Health Organization, Dr Saleh Fares, President Elect, attended a large meeting in Norway to discuss Emergency Care Minimum Datasets and Dr Imron Subhan, WHO Taskforce Chair, assists the roll-out of Basic Emergency Care and other WHO courses.

What about the lows? Well as we all work together on these exciting initiatives, often colleagues around the world in different time zones join me on Zoom on return home from a shift. Wherever they work, I am hearing the same message. We are tired. Our departments are too full of patients. Our specialist colleagues resist helping because they too, are tired. The pandemic continues to take its toll, but it wasn’t too good even before that. The end result of these poor working conditions is fatigue and low morale for us, with long waiting times and crowded conditions for patients.

Over-crowding harms staff and patients. No, that statement is not over-dramatic! The evidence is clear. Morley et al identified 40 studies describing adverse consequences of crowding, where six studies showed an association between crowding and mortality. Morley et al (2018). Emergency department crowding: A systematic review of causes, consequences and solutions.

Jones et al in the UK show that long waiting times for hospital admission increase mortality. Jones et al (2021). Association between delays to patient admission from the emergency department and all-cause 30-day mortality. 

Where you work, what is the cause?

1. Too many patients coming to the Emergency Department? (poor community and primary care, ambulance staff not empowered to decide not to take the patient to hospital etc)
2. Problems with the process of managing the patients? (staff levels, equipment, computer systems etc)
3. No hospital beds to move on to? Global comparisons are always fascinating. OECD 2021 data shows that the number of hospital beds per 1000 population varies from less than 1/1000 (India, Mexico, Indonesia) to to 12/1000 (South Korea, Japan). Is it a coincidence that at just 2/1000 (UK, Canada, USA) these countries right now have extreme problems with emergency ambulances unable to physically move the patient from the ambulance into the hospital building due to no patient flow?

The scene looks chaotic and disastrous. Our specialist colleagues are not expected to work in such conditions. This week IFEM is holding two focus groups to consider this topic. Watch this space as we take action….

Let’s work together to develop this conversation. Keep an eye on our website, social media and newsletters to contribute. We also welcome messages to [email protected]

Dr Ffion Davies
IFEM President