Emergency Medicine Resident Work Productivity in an Academic Emergency Department

DeBehnke, Daniel J.; O'Brien, Shawn; Leschke, Robert

doi:10.1111/j.1553-2712.2000.tb01899.x

Cited by 50 publications

(54 citation statements)

References 9 publications

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“…They found that upper-level residents not only saw more patients than did interns (PGY-2 and PGY-3 residents saw 1.2 and 1.22 PPH, respectively, vs. 0.79 PPH for PGY-1 residents) but also were more efficient in terms of shorter patient lengths of stay. 7 In the earliest report of EM resident clinical experience, Langdorf et al tracked 33 EM residents in three participating EDs with a combined census of 100,000 annual patient visits. They found EM-1 residents averaged 0.73 PPH, EM-2 residents averaged 0.85 PPH, and EM-3 residents averaged 1.19 PPH.…”

Section: Discussionmentioning

confidence: 99%

Progression of Emergency Medicine Resident Productivity

Brennan

Silvestri

Sun

et al. 2007

Academic Emergency Medicine

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Objectives: To evaluate the progression in productivity of emergency medicine (EM) residents by postgraduate year, as measured by hourly work in relative value units (RVUs).Methods: This retrospective study was conducted at an Accreditation Council for Graduate Medical Education (ACGME)-accredited EM residency with a postgraduate year (PGY) 1-2-3 configuration. A query of an electronic billing database composed of more than 230,000 visits from academic years July 2003 to December 2006, representing at least four classes at each PGY level, was conducted. The main outcome was change in productivity in RVUs generated per hour, compared by resident PGY level. This measure encompasses not only volume of patients seen but also patient acuity in terms of evaluation and management services and procedures provided and supported by documentation adequate for coding. Descriptive statistics and Tukey's test were used for data analysis.Results: Over the three-year study period, 70 EM residents were assessed at various levels of training. Productivity, as measured by mean RVUs generated per hour, was 2.51 (95% confidence interval [CI] = 2.20 to 2.82) for PGY-1 residents, 3.51 (95% CI = 3.12 to 3.90) for PGY-2 residents, and 3.61 (95% CI = 3.41 to 3.80) for PGY-3 residents (p < 0.001). Patient acuity (RVUs generated per patient) increased 5%-8% with each PGY progression: 3.05 (95% CI = 2.96 to 3.13) for PGY-1, 3.20 (95% CI = 3.09 to 3.31) for PGY-2, and 3.46 (95% CI = 3.42 to 3.50) for PGY-3 (p < 0.001). There was a statistically significant increase in productivity (p < 0.001) and acuity (p = 0.03) from PGY-1 to PGY-2, with acuity also increasing between PGY-2 and PGY-3 (p < 0.001).Conclusions: Hourly work productivity and acuity increased with experience within this ACGMEaccredited EM residency. The progression in workload and acuity by PGY is measurable and commensurate with the graduated level of responsibility desired in an EM program.

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Section: Discussionmentioning

confidence: 99%

Progression of Emergency Medicine Resident Productivity

Brennan

Silvestri

Sun

et al. 2007

Academic Emergency Medicine

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“…Previous studies of longer residency programs report that more senior residents training in emergency medicine reduces wait times and provides more effective physician-patient communication. 12,13 However, one study reported that more senior residents resulted in greater total LOS. 1 …”

Section: Discussionmentioning

confidence: 99%

Impact of Family Medicine Resident Physicians on Emergency Department Wait Times and Patients Leaving Without Being Seen

Dalal

2015

CJEM

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Objective: To quantify the effect of family medicine resident physicians on emergency department (ED) wait times and patients leaving without being seen or treated. Methods: In a medium-volume community ED over twelve months, we used retrospective chart review to compare wait times between patients seen during shifts where staff were working alone versus with a resident. We measured the time from initial triage time to physician initial assessment (T 1 ) and disposition time (LOS), and number of patients leaving without being seen or treated. Results: In our analysis, 21,141 patients (91% of total visits) were included; 48% were in the staff-with-resident group, and 52% were in the staff-only group. Mean T 1 in the resident group was significantly shorter than the staff-only group (1 hour 23 minutes versus 1 hour 38 minutes, difference 15 minutes, 95% CI 13 to 17 minutes, p < 0.001). Mean total LOS in the resident group was also reduced (2 hours 38 minutes versus 2 hours 50 minutes, difference 12 minutes, 95% CI 8 to 17 minutes, p < 0.001). Fewer patients left without being seen in the resident group than the staff only group (2.8% versus 4.9%, p < 0.001). There were no differences in patients leaving without being treated (0.5% versus 0.5%). Conclusions: This is the first study to demonstrate that residents are associated with a reduction in ED wait times and patients leaving without being seen in a low-acuity, community hospital, compared to previous studies demonstrating no difference or increased wait times. RÉSUMÉObjectif: L'étude visait à quantifier l'effet des résidents en médecine familiale sur les délais d'attente aux services des urgences (SU) et sur le départ des patients sans avoir été vus ou traités. Méthode: Les auteurs ont procédé à un examen rétrospectif de dossiers médicaux ouverts dans un SU d'un hôpital communautaire de capacité moyenne, sur une période de 12 mois, pour comparer les délais d'attente des patients entre les périodes de travail où le personnel travaillait seul, sans résident, et celles où il travaillait avec un résident. Ont été calculés le temps écoulé depuis le moment du triage initial jusqu'à l'évaluation initiale par un médecin (T 1 ) et la durée de séjour (DS) quant aux suites à donner ainsi que le nombre de patients partis sans avoir été vus ou traités. Résultats: Dans l'ensemble, 21 141 patients (91 % de toutes les consultations) ont été inclus dans l'analyse; 48 % d'entre eux se sont trouvés dans le groupe du personnel accompagné de résidents, et 52 %, dans le groupe du personnel seul. Le T 1 moyen dans le groupe où il y avait des résidents était significativement plus court que celui dans le groupe où le personnel était seul (1 heure 23 minutes contre 1 heure 38 minutes; écart: 15 minutes; IC à 95 %: 13 à 17 minutes; p < 0,001). La durée totale moyenne de séjour était également plus courte dans le groupe de résidents que dans l'autre groupe (2 heures 38 minutes contre 2 heures 50 minutes; écart: 12 minutes; IC à 95 %: 8 à 17 minutes; p < 0,001). En outre, moins d...

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“…Studies on laboratory performance of the 690 hospitals have considered the improvement of the throughput times of the patients associated with the quality of sample management in labs and the rate of sample transfer 20 .…”

Section: Discussionmentioning

confidence: 99%

Comparing the patients' throughput in an Emergency Department in Tabriz city with International Standards

Haghighi¹,

Vahdati²,

Namin³

et al. 2014

Sakarya Med J

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Introduction: Emergency department (ED) patients'throughput includes all the processes that patients go through; this study was designed to investigate the patients throughput and the duration of stay in this department. Methods: In a prospective cross-sectional study, we evaluated the association between workflow process and admission duration in emergency department of Sina hospital of Tabriz from March 20th to July 20th 2011. Result: We studied 800 randomly selected patients referred to the emergency department between 20th March and 20th July 2011. The mean time duration between first visit and disposition was 64.94± 64.7 min (mode= 24min). The most prevalent chief complaint was common cold in which was presented in 448 patients Discussion: In the management of emergency department, all of parts must work as a member of team and if one of these members has a problem and does not work properly then pass-through will be happen.

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Emergency Medicine Resident Work Productivity in an Academic Emergency Department

Cited by 50 publications

References 9 publications

Progression of Emergency Medicine Resident Productivity

Progression of Emergency Medicine Resident Productivity

Impact of Family Medicine Resident Physicians on Emergency Department Wait Times and Patients Leaving Without Being Seen

Comparing the patients' throughput in an Emergency Department in Tabriz city with International Standards

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