A nationwide survey of emergency medicine resident workflow efficiency: Are training programs teaching residents to be efficient?

Carmelli, Guy; Watson, Erin; Villarroel, Nadia Aracelliz; Dixon, William; Clarke, Samuel

doi:10.1002/aet2.10598

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…stages in training has been previously characterized, [7][8][9] but there is little standardization in how residency programs use productivity data in resident education, what format is most useful, and how residents perceive and apply the data. 10 Residents at our urban, academic institution, which has an annual patient volume of over 90,000 patients, requested more feedback regarding their productivity directly from residency leadership and through the annual Accreditation Council for Western Journal of Emergency Medicine…”

Section: Discussionmentioning

confidence: 99%

“…The development and dissemination of productivity data has been requested by our residents both informally and formally through the annual ACGME survey, and this is an area of interest to many residents and educators. 10,[13][14][15] The resident sentiment regarding our implementation, however, was mixed. Residents seemed skeptical of how accurately the data provided reflected their work, feeling it was less accurate in reflecting their quality of care than their productivity.…”

Section: Discussionmentioning

confidence: 99%

“… 6 The productivity of EM residents at various stages in training has been previously characterized, 7 – 9 but there is little standardization in how residency programs use productivity data in resident education, what format is most useful, and how residents perceive and apply the data. 10 …”

Section: Introductionmentioning

confidence: 99%

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Resident Perceptions of a Publicly Disclosed Daily Productivity Dashboard

Goldflam

Tsyrulnik

Flood

et al. 2022

WestJEM

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Introduction: Following resident requests, we created a public metrics dashboard to inform residents of their daily productivity. Our goal was to iteratively improve the dashboard based on resident feedback and to measure the impact of reviewing aggregate data on self-perceived productivity. Methods: A 10-question anonymous survey was completed by our postgraduate year 1-3 residents. Residents answered questions on the dashboard and rated their own productivity before and after reviewing aggregate peer-comparison data. Using the Wilcoxon signed-rank test we calculated summary statistics for survey questions and compared distributions of pre- and post-test, self-rated productivity scores. Results: All 43 eligible residents completed the survey (response rate 100%). Thirteen (30%) residents “rarely” or “never” reviewed the dashboard. No respondents felt the dashboard measured their productivity or quality of care “extremely accurately” or “very accurately.” Seven (16%) residents felt “very” or “extremely pressured” to change their practice patterns based on the metrics provided, and 28 (65%) would have preferred private over public feedback. Fifteen residents (35%) changed their self-perceived rank after viewing peer-comparison data, although not significantly in a particular direction (z = 0.71, P = 0.48). Conclusion: Residents did not view the presented metrics as reflective of their productivity or quality of care. Viewing the dashboard did not lead to statistically significant changes in resident self-perception of productivity. This finding highlights the need for expanding the resident conversation and education on metrics, given their frequent inclusion in attending physician workforce payment and incentive models.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Resident Perceptions of a Publicly Disclosed Daily Productivity Dashboard

Goldflam

Tsyrulnik

Flood

et al. 2022

WestJEM

View full text Add to dashboard Cite

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Identifying relevant topics and training methods for emergency department flow training

Young

Patey²,

Norman³

et al. 2022

Can J Emerg Med

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Purpose Despite the importance of patient flow to emergency department (ED) management, there is a need to strengthen and expand training in flow strategies for practicing ED staff. To date, there has been limited academic inquiry into the skills and training that ED staff require to improve patient flow. As part of a quality improvement initiative, our team aimed to identify the topics and training methods that should be included in flow training for ED staff. Methods We conducted an integrative review and modified Delphi. For the integrative review, we sought to identify appropriate skills, training strategies, and training modalities to include in a curriculum for ED staff. The findings from the review were compiled and distributed to Canadian experts in ED efficiency through a modified Delphi, including physicians, nurses, and nurse practitioners. Results Our literature search retrieved 8359 articles, of which 46 were included in the review. We identified 19 skills, 9 training strategies, and 12 training modalities used to improve ED efficiency in the literature. For the modified Delphi, we received responses from 39 participants in round one and 28 in round two, with response rates of 57% and 41%, respectively. The topics chosen by the most respondents were: “flow decisions,” “teamwork,” “backlog and surge management,” “leadership,” and “situational awareness.” Conclusion Our findings suggest that flow training should teach ED staff how to make decisions that improve flow, work more effectively as a team, manage patient backlog and surge, improve leadership skills, and develop situational awareness. These findings add to a gap in the academic literature regarding the training ED staff require to improve patient flow.

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