Section 5: Adapting and Evolving in a Changing World
Section Editors: Ivy Cheng, Alecs Chochinov
The final section of the EM:POWER report looks at major disruptive forces and trends in the global ecosystem that will reshape our work world in the decades to come. The chapters that comprise this section are derived from the biomedical, natural, and social sciences and cover a broad range of subjects, ranging from digital health to climate change.
Chapter 9: Just as we have made recommendations for clinical care, we begin with an exploration of integrating EM research into a broader system. This underlines the importance of tailoring research efforts to the biggest threats to our patients, populations, and planetary health.
Chapter 10: This chapter examines digital health (DH), addressing the potential of new technologies to transform how we communicate with each other, and care for patients virtually. The challenge for us is one of leadership and stewardship, to ensure that DH’s vast potential is realized in a cost-effective way that puts meaningful patient outcomes first and doesn’t drain valuable human resources from our EDs.
Chapter 11: Conflict and differing perspectives are major barriers to collaboration in service of the Quintuple Aim, especially in the ED. Sometimes differing perspectives appear inexplicable, leaving ED care providers frustrated and morally distressed. This chapter, entitled Managing Intergroup Relations, explains that understanding group dynamics and social identity are keys to moving out of our siloed past and collectively achieving better outcomes for patients.
Chapter 12: The EM:POWER project is a prime example of emergency medicine’s potential role in health policy and public affairs. In this chapter, the metaphor of the ED as the passive canary in the coal mine of health system dysfunction is challenged, and replaced with a more empowered construct, in which EM is a leading agent of change.
Chapter 13: Climate change is arguably the biggest health threat of the 21st century; yet many of us have an inadequate understanding of its impact on our patients and health system. This chapter includes a series of recommendations on how as physicians with expert knowledge and global responsibilities, we can prepare ourselves and our EDs for the impact of climate instability, mitigate the effects on our patients, and educate others.
Chapter 14: Boasting the acronym JEDI (not the Star Wars version) this chapter takes us full circle to the core values and principles that must guide us through an uncertain future. It outlines the challenges facing marginalized populations in the ED, with recommendations that focus on achieving a broader understanding of our diverse populations and equitable emergency care for all patients.
Chapter 15: This section ends with an exploration of healthcare strategies and lessons from other countries with liberal democratic values but different health systems. In an increasingly integrated world—and with the health of our patients at stake—it promotes the goal of becoming a true Learning Health System in which we use global knowledge and experience to continually improve.