Increasing Off-Service Resident Productivity while on their Emergency Department Rotation Using Shift Cards

Abstract

, Abstract-Background: Differences in productivity between off-service residents rotating in the emergency department (ED) and their emergency medicine (EM) resident counterparts have never been directly quantified. Objectives: We sought to quantify the difference between off-service residents rotating in the ED and their EM resident counterparts. We also sought to find whether shift cards could be used to increase the productivity of off-service residents rotating in the ED. Methods: This is a prospective cohort study conducted at an urban, tertiary, Level I trauma center. We implemented the use of shift cards for off-service residents during their EM rotation. Completion of the shift card involved recording patients seen and their dispositions, procedures done, and documenting a learned bedside teaching point from their shift that day. Productivity was measured in terms of patients seen per hour (PPH) and relative value units per hour (RVU/h). Results: Off-service residents showed a productivity of 0.529 PPH (95% confidence interval [CI] 0.493-0.566) and 1.40 RVU/h (95% CI 1.28-1.53) prior to implementation of shift cards. With the introduction of shift cards, productivity increased to 0.623 PPH (95% CI 0.584-0.663, p = 0.001) and 1.77 RVU/ h (95% CI 1.64-1.91, p = 0.001). In comparison, first year EM resident productivity was 0.970 PPH (95% CI 0.918-1.02) and 3.01 RVU/h (95% CI 2.83-3.19). Conclusions: Shift cards can be used to foster motivation for off-service residents rotating in the ED, and is a simple and costeffective method to improve system-based practices and utilization of resources. Ó 2015 Elsevier Inc.

Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2015

“…A total of 434 papers and abstracts satisfied the search criteria, and 61 papers met the inclusion criteria . The authors scored these 61 manuscripts, and the 10 highest scoring quantitative and two qualitative articles are reviewed below, in alphabetical order by first author's last name.…”

“…There were 10 papers (16%) that employed survey methodology but none met the criteria for a highlighted article . The remaining 36 papers (59%) were observational studies and accounted for 50% of the highlighted articles . It is interesting to note that each study design had representation in meeting the validated criteria to be a highlighted article, with the exception, this year, of survey methodology.…”

“…The study populations included medical students (36%), residents (54%), and a variety of others (attending physicians, nurses, interprofessional teams, fellows, midlevel providers, paramedics, validity evidence, and department flow).…”