The Emergency Department (ED) setting often presents situations where the doctor–patient relationship is fundamental and may be challenging. Thus, it is important to use effective communication to improve outcomes. This study explores patients’ experience of communication with the medical team aiming to discover whether there are some objective factors which may affect their perception. A prospective, cross-sectional study in two hospitals: an urban, academic trauma center and a small city hospital. Adult patients discharged from the ED in October 2021 were consecutively included. Patients filled out a validated questionnaire, the Communication Assessment Tool for Teams (CAT-T), assessing communication perception. Additional data about the participants were collected by the physician in a dedicated tab to assess whether there were objective factors influencing the patient’s perception of the medical team's communication skills. Statistical analysis was then performed. 394 questionnaires were analyzed. The average score for all items exceeded 4 (good). Younger patients and patients who were conveyed by ambulance attributed lower scores than other groups (p value < 0.05). A significant difference between the two hospitals was also observed in favour of the bigger hospital. In our study long waiting times did not generate less satisfied responses. The item which received the lowest scores was “the medical team encouraged me to ask questions”. Overall, patients were satisfied with doctor–patient communication. Age, setting, way of conveyance to the hospital are objective factors that may influence patients’ experience and satisfaction in the ED.

Patient safety is a significant concern worldwide. The Emergency Departments (EDs) are vulnerable to adverse events. Europe, with its diverse healthcare systems, differs in patient safety. This study aimed to identify safety challenges through a comparative analysis of healthcare professionals’ perceptions of patient safety in European EDs. In early 2023, a validated questionnaire was distributed to European ED professionals, meeting specific response rate criteria. The questionnaire included five safety domains and additional questions about infection control and team morale, with 36 ordinal scale questions. Responses ranged in five levels from “Never” to “Always,” and the scores were summed to calculate the total safety score (TSS). The study examined the impact of per capita healthcare expenditure on safety perceptions using descriptive statistics, correlation assessments and SPSS 17 used for the analysis. The analysis of 1048 valid responses from 24 European countries revealed significant variability in safety perceptions. Teamwork scored highest, signifying effective collaboration. Common safety issues included overcrowding, patient flow management, understaffing, limited training and facilities for mental illnesses. TSS showed correlation with team morale and infection control, but no correlation with per capita healthcare expenditure. This comparative study underlines the disparities in patient safety perceptions across European EDs. Each country displayed unique safety concerns. Safety perceptions did not align with per capita healthcare expenditure, indicating that addressing ED safety needs multifaceted strategies. Policymakers can leverage these findings to inform strategic planning, encouraging targeted interventions to enhance patient safety at both the national and European levels.

The Swiss Ticino regional pulmonary embolism response team (PERT) features direct access to various pharmacomechanical PE management options within a hub/spoke system, by integrating evidence, guidelines’ recommendations and personal experiences. This system involves a collaborative management of patients among the hospitals distributed throughout the region, which refer selected intermediate–high or high PE patients to a second-level hub center, located in Lugano at Cardiocentro Ticino, belonging to the Ente Ospedaliero Cantonale (EOC). The hub provides 24/7 catheterization laboratory activation for catheter-based intervention (CBI), surgical embolectomy and/or a mechanical support system such as extracorporeal membrane oxygenation (ECMO). The hub hosts PE patients after percutaneous or surgical intervention in two intensive care units, one specialized in cardiovascular anesthesiology, to be preferred for patients without relevant comorbidities or with hemodynamic instability and one specialized in post-surgical care, to be preferred for PE patients after trauma or surgery or with relevant comorbidities, such as cancer. From April 2022 to December 2023, a total of 65 patients were referred to the hub for CBI, including ultrasound-assisted catheter-directed thrombolysis (USAT) or large-bore aspiration intervention. No patient received ECMO or underwent surgical embolectomy.

Background and importance: Climate change is widely recognised as a critical public health challenge. Objective: The objective of this study was to assess the awareness, preparedness and mitigation plans for climate change threats. Design, settings and participants: A cross-sectional observational study targeting emergency medical societies in different countries was conducted between 15 February and 15 March 2024. Intervention or exposure: The survey featured 16 closed questions on climate change awareness, preparedness and risks. Focus groups of 4–6 members were organised by country. Results were correlated to income levels, United Nations (UN) regional classification and the World Risk Index. Outcome measure and analysis: The questions were ranked using a Likert-like scale from 0 to 9 (9 being the highest). Descriptive statistics used central tendency estimators, and inferential analysis used chi-square and Kruskal–Wallis tests, with the significance level set at P < 0.05. Results: Forty-two focus groups responded, representing 36 countries: 21 (50%) high-income, seven (16.7%) low-income, five (11.9%) lower middle-income and nine (21.4%) upper middle-income countries, representing 31 of the 22 UN regions. According to the World Risk Index, the respondent countries belonged to the different categories as follows: very low risk, 6 (14%); low risk, 8 (19%); medium risk, 5 (12%); high risk, 8 (19%) and very high risk, 14 (34%). The estimated impact of climate change on national health systems had a mean score of 6.75 (SD = 2.16), while on Emergency Medical Systems was 6.96 (SD = 2.05). Overall, assessment and preparedness measures were reported by just 21.4 and 37.6% of respondents, respectively. Analysis by income did not show significant differences, with the exception of food supply. The main differences in the analysis by region were the risks of extreme weather events, vector-borne diseases and wildfires, whereas the World Risk Index was food and chain of supplies. Education and integration of health services were indicated by all as the main mitigation actions. Conclusion: Geographical position and country risk index influence risk perception among focus groups more than income economy, with vector-borne diseases, extreme weather events and food shortages being the threats with the most variability. The most important actions identified to mitigate Climate Change effects are educational and strategic plans.