The Effect of Emergency Medicine Residents on Clinical Efficiency and Staffing Requirements.

Autor: Clinkscales JD; Department of Emergency Medicine, Erlanger Institute for Clinical Research, University of Tennessee College of Medicine Chattanooga, Erlanger Health System, Chattanooga, TN., Fesmire FM; Department of Emergency Medicine, Erlanger Institute for Clinical Research, University of Tennessee College of Medicine Chattanooga, Erlanger Health System, Chattanooga, TN., Hennings JR; Department of Emergency Medicine, Erlanger Institute for Clinical Research, University of Tennessee College of Medicine Chattanooga, Erlanger Health System, Chattanooga, TN., Severance HW; Department of Emergency Medicine, Erlanger Institute for Clinical Research, University of Tennessee College of Medicine Chattanooga, Erlanger Health System, Chattanooga, TN., Seaberg DC; Department of Emergency Medicine, Erlanger Institute for Clinical Research, University of Tennessee College of Medicine Chattanooga, Erlanger Health System, Chattanooga, TN., Patil N; Department of Quality Management, Greenville Health System, Greenville, SC.
Jazyk: angličtina
Zdroj: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine [Acad Emerg Med] 2016 Jan; Vol. 23 (1), pp. 78-82. Date of Electronic Publication: 2015 Dec 29.
DOI: 10.1111/acem.12834
Abstrakt: Objectives: The effect of emergency medicine (EM) residents on the clinical efficiency of attending physicians is controversial. The authors hypothesized that implementing a new EM residency program would result in an increase in relative value units (RVUs) generated per hour by attending physicians and decrease staffing requirements.
Methods: This was a retrospective observational analysis of an emergency department before, during, and after the establishment of a new EM residency program. We analyzed the change in RVUs billed, patients seen, and hours worked by attending physicians, midlevel providers (MLPs), and residents, and addressed potential confounding factors.
Results: The clinical efficiency of attending physicians increased by 70%, or 4.98 RVUs/hour (from 7.12 [SD ± 1.4] RVUs/hour to 12.1 [SD ± 2.2] RVUs/hour, p < 0.001) with the implementation of an EM residency program. Overall, net department RVU generation rose by 32%, even as attending physician coverage decreased by 6.3% (p < 0.05), and MLP coverage dropped by 60% (p < 0.05). We estimated that the implementation of the residency saved 4,860 hours of attending physician coverage and 5,828 hours of MLP coverage per year. This represents an estimated $1,741,265 in annual staffing savings, comparable to the residency program's annual operating cost of $1,821,108.
Conclusions: The implementation of an EM residency program had a positive effect on the clinical efficiency of attending physicians and decreased staffing requirements.
(© 2015 by the Society for Academic Emergency Medicine.)
Databáze: MEDLINE
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