Abstract
The aim of this study was to identify factors associated with distress experienced by physicians during their first coronavirus disease 2019 (COVID-19) triage decisions. An online survey was administered to physicians licensed in New York State. Of the 164 physicians studied, 20.7% experienced severe distress during their first COVID-19 triage decisions. The mean distress score was not significantly different between physicians who received just-in-time training and those who did not (6.0 ± 2.7 vs 6.2 ± 2.8; P = 0.550) and between physicians who received clinical guidelines and those who did not (6.0 ± 2.9 vs 6.2 ± 2.7; P = 0.820). Substantially increased odds of severe distress were found in physicians who reported that their first COVID-19 triage decisions were inconsistent with their core values (adjusted odds ratio, 6.33; 95% confidence interval, 2.03-19.76) and who reported having insufficient skills and expertise (adjusted odds ratio 2.99, 95% confidence interval 0.91-9.87). Approximately 1 in 5 physicians in New York experienced severe distress during their first COVID-19 triage decisions. Physicians with insufficient skills and expertise, and core values misaligned to triage decisions are at heightened risk of experiencing severe distress. Just-in-time training and clinical guidelines do not appear to alleviate distress experienced by physicians during their first COVID-19 triage decisions.
Highlights
State experienced one of the most devastating rises to peak levels of novel coronavirus cases in the United States, characterized early on by a lack of personal protective equipment and ventilators.[1]
Our study aims to assess factors, such as COVID-19-related JiTT and clinical guidelines, associated with distress experienced by physicians during their first COVID-19 triage decisions
Most indicated that their first COVID-19 triage decision was consistent with their core values (136 [82.9%])
Summary
State experienced one of the most devastating rises to peak levels of novel coronavirus cases in the United States, characterized early on by a lack of personal protective equipment and ventilators.[1] On March 23, Governor Andrew Cuomo ordered New York hospitals to increase their capacity by 50% to accommodate the anticipated patient surge.[2] Clinicians, health system administrators, and public health officials began considering the need for alternative standards of care to address the problem of scarce resource allocation
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