Slow or swift, your patients’ experience won’t drift: absence of correlation between physician productivity and the patient experience

Lenz, Kasia; McRae, Andrew; Wang, Dongmei; Higgins, Benjamín; Innes, Grant; Cook, Timothy Wayne; Lang, Eddy

doi:10.1017/cem.2016.385

Cited by 4 publications

(10 citation statements)

References 30 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Researchers in five (9%) of the 54 studies provided a definition of patient experience (Supplementary File 4). [35][36][37][38][39] Three studies defined patient experience in relation to why it is a preferable measure for quality improvement as opposed to patient satisfaction. [35,36,39] These definitions stated that patient experiences "have shown to be more objective and to yield more detailed information for quality improvement" [35,36] as they "provide information identifying where in the process problems may reside and what can be done to improve patient care".…”

Section: Definitions Of 'Patient Experience'mentioning

confidence: 99%

“…[35] Another study proposed a patient experience definition based on the domains addressed by the patient experience survey they employed. [37] These domains included staff care, pain management, discharge communication, respect, medication communication, and wait time and crowding. [37] Another study defined the patient experience as a combination of There is overlap between these themes due to the complex interplay between patients, care providers and the ED environment.…”

Section: Definitions Of 'Patient Experience'mentioning

confidence: 99%

“…[37] These domains included staff care, pain management, discharge communication, respect, medication communication, and wait time and crowding. [37] Another study defined the patient experience as a combination of There is overlap between these themes due to the complex interplay between patients, care providers and the ED environment. The overlap contributes to a unified and holistic conceptualisation of patient experiences in the ED.…”

Section: Definitions Of 'Patient Experience'mentioning

confidence: 99%

“…However, when relational respect was minimal or absent, patients reported more negative experiences. This occurred when ED care providers talked in front of patients as if they were not there, [37,58,68,70,71] when patients felt they were not taken seriously, [45,63,65,66,72] were disregarded, [45,73] treated with judgement or discrimination, [41,42,45,68,72,74] or humiliated. [41,45,62,74]…”

Section: Respecting Patientsmentioning

confidence: 99%

“…Patients valued emotional aspects of care as it made them feel important and understood by their care providers,[40,48,49,65,81] such as when empathy and genuine concern was demonstrated. [38-40, 43, 45, 47, 49, 56, 60, 65, 81, 82, 86] This occurred when care providers used reassuring words, touch and body language,[40,41,47,49,68,79] when they informed patients' family or friends that they were in the ED,[48,49,61,68,75,82] and by ensuring patients did not feel lonely [37,40,48,49,64,68,[80][81][82]. Receiving an inadequate level of emotional support[40, 43,44,49,65,72,73] or follow-up responsibility for and control of patients' care,[39,41,49,61,88] were efficient and responsive,[37,40,41,45,48,49,56,66,…”

mentioning

confidence: 99%

See 4 more Smart Citations

A systematic mixed studies review of patient experiences in the ED

et al. 2021

View full text Add to dashboard Cite

BackgroundUnderstanding patient experiences is crucial to evaluating care quality in EDs. However, while previous reviews describe the determinants of ED patient experiences (ie, factors that influence patient experiences), few have described actual patient experiences. The aim of this systematic mixed studies review was to describe patient experiences in the ED from the patient’s perspective.MethodsEmbase, Medline, ProQuest Nursing and Allied Health, the Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library electronic databases were searched, with publication dates limited between 1 January 2001 and 16 September 2019. Studies describing adult patient experiences in the ED were included. Studies describing patient satisfaction, proxy-reported experiences or child/adolescent experiences were excluded. The quality of included studies was appraised using the Mixed Methods Appraisal Tool (2018 version). An inductive, convergent qualitative synthesis of the extracted data was undertaken following Thomas and Harden’s (2008) methods.ResultsFifty-four studies were included and of those, only five (9%) studies included a standardised definition of patient experience. Two inter-related themes emerged: Relationships between ED patients and care providers; and Spending time in the ED environment. The first theme included four subthemes regarding respect, communication, caring behaviours and optimising patient confidence. A key finding related to the potential for power imbalances between patients and their care providers. The second theme included two subthemes regarding physical aspects of the ED environment and patients’ waiting experience. Patients attributed more importance to the waiting experience itself rather than the duration they had to wait.ConclusionsPatients in the ED have unique and complex experiences. Greater research is needed to understand the relational and environmental factors that contribute to power imbalances between patients and care providers, how to support more positive waiting experiences, and developing a standardised definition of patient experience in the ED.PROSPERO registration numberCRD42020150154.

show abstract

Section: Definitions Of 'Patient Experience'mentioning

confidence: 99%

Section: Definitions Of 'Patient Experience'mentioning

confidence: 99%

Section: Definitions Of 'Patient Experience'mentioning

confidence: 99%

Section: Respecting Patientsmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

A systematic mixed studies review of patient experiences in the ED

et al. 2021

View full text Add to dashboard Cite

show abstract

Fast does not imply flawed: Analyzing emergency physician productivity and medical errors

et al. 2022

View full text Add to dashboard Cite

Objective To determine whether emergency physician productivity is associated with the risk of medical errors. Methods We retrospectively analyzed quality assurance (QA) and billing data over 3 years at 2 urban emergency departments. Faculty physicians working 400 hours or more at either site were included. We measured physician years of experience, age, gender, patients seen per hour (PPH), and relative value units billed per hour (RVU/h). From an established QA process, we obtained adjudicated medical errors to calculate rates of medical errors per 1000 patients seen as the outcome. We discretized numeric variables and used Kruskal–Wallis testing to examine relationships between independent variables and rates of medical errors. Results We included data for 39 physicians at site A and 42 at site B. The median rate of errors per 1000 patients was 1.6 (interquartile range [IQR], 1.1–1.9) at site A and 3.3 (IQR, 2.4–3.9) at site B. At site A, RVU/h was associated with error rates ( P = 0.03), with medians of 2.0, 1.2, 1.7, and 1.3 errors per 1000 patients, from slowest to fastest quartiles. At site B, PPH was associated with error rates ( P < 0.01), with medians of 3.9, 3.7, 2.4, and 2.7 errors per 1000 patients, from slowest to fastest quartiles. There was no significant relationship between error rates and PPH at site A or RVU/h at site B. Conclusions Rates of medical errors were associated with 1 metric of physician productivity at each site, with higher error rates seen among physicians with slower productivity.

show abstract

Definitions and factors associated with emergency physician productivity: a scoping review

et al. 2023

View full text Add to dashboard Cite

Purpose There currently exists no standard productivity measure for emergency physicians. The objectives of this scoping review were to synthesize the literature to identify components of definitions and measurements of emergency physician productivity and to evaluate factors associated with productivity. Methods We searched Medline, Embase, CINAHL, and ProQuest One Business from inception to May 2022. We included all studies that reported on emergency physician productivity. We excluded studies that only reported departmental productivity, studies with non-emergency providers, review articles, case reports, and editorials. Data were extracted into predefined worksheets and a descriptive summary was presented. Quality analysis was performed with Newcastle-Ottawa Scale. Results After screening 5521 studies, 44 studies met full inclusion criteria. Components of the definition for emergency physician productivity included: number of patients managed, revenue generated, patient processing time, and a standardization factor. Most studies measured productivity using patients per hour, relative value units per hour, and provider-to-disposition time. The most studied factors influencing productivity included scribes, resident learners, electronic medical record implementation, and faculty teaching scores. Conclusion Emergency physician productivity is heterogeneously defined, but includes common elements such as patient volume, complexity, and processing time. Commonly reported productivity metrics include patients per hour and relative value units that incorporate patient volume and complexity, respectively. The findings of this scoping review can guide ED physicians and administrators to measure the impact of QI initiatives, promote efficient patient care, and optimize physician staffing.

show abstract

Slow or swift, your patients’ experience won’t drift: absence of correlation between physician productivity and the patient experience

Abstract: We found no correlation between EP productivity and the patient experience.

Cited by 4 publications

References 30 publications

A systematic mixed studies review of patient experiences in the ED

A systematic mixed studies review of patient experiences in the ED

Fast does not imply flawed: Analyzing emergency physician productivity and medical errors

Definitions and factors associated with emergency physician productivity: a scoping review

Contact Info

Product

Resources

About