Tackling the demand for emergency department services: there are no silver bullets

Authors’ response to ‘Impact of physician navigators: looking beyond productivity metrics and silver bullets’ by Leunget al

“…We would like to thank Dr Leung et al 1 and the editors for the opportunity to engage in further discussion on the issues presented in our commentary entitled ‘Tackling the demand for emergency department services: there are no silver bullets’ 2. We believe that the intervention proposed by Leung et al 3 demonstrated improved timeliness to definitive patient care and was an important contribution to the medical literature around emergency department (ED) flow optimisation.…”

Impact of Physician Navigators: Looking beyond productivity metrics and silver bullets

“…We thank Mercuri and Mondoux for their commentary1 on our study which introduced Physician Navigators as a novel intervention to improve ED productivity and efficiency 2. The authors expressed concern about the potential trade-off between improved productivity and compromised patient outcomes, and described Physician Navigators as limited to improving timely care with potential negative consequences on the other dimensions of quality.…”

“…Although the physician is only a part of the barrier to ED flow,1 it is a major source worth addressing. Physicians who complete non-clinical tasks that could otherwise be delegated to a Physician Navigator constitute wasteful utilisation of resources.…”

“…Mercuri and Mondoux1 advocate for comprehensive studies that examine the impact of ED operation interventions across all dimensions of quality health and on inpatient services. We agree that this is the ideal, but is not always feasible in research.…”

“…The problem of increased demand for emergency services in a setting of limited resources is a problem that is projected to only worsen. If the ultimate long-term goal of ED operational research is on ‘bringing interventions together’,1 then something must be done today, even if it only addresses one dimension of quality care at a time.…”