Emergency medicine resident productivity across consecutive shifts.

Autor: Shaw DL; Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA., Kravitz MS; Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA., Stenson BA; Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA., Lewis JJ; Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA., Chiu DT; Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA.
Jazyk: angličtina
Zdroj: AEM education and training [AEM Educ Train] 2024 Feb 09; Vol. 8 (1), pp. e10935. Date of Electronic Publication: 2024 Feb 09 (Print Publication: 2024).
DOI: 10.1002/aet2.10935
Abstrakt: Objectives: Clinical productivity is an important operational and educational metric for emergency medicine (EM) residents. It is unclear whether working consecutive days and circadian disruption impact resident productivity. The objective of this study was to determine whether there is a correlation between consecutive shifts and productivity.
Methods: This was a single-site retrospective observational study using data from academic year 2021-2022 (July 1, 2021-June 23, 2022). Productivity was defined as primary resident encounters with patients per hour (PPH). Postgraduate year (PGY)-1 and PGY-2 productivity data and schedules were abstracted from the electronic medical record and scheduling software. Descriptive statistics, including arithmetic mean, standard deviation, and confidence interval (CI), were determined for each shift number and stratified by PGY level. Subgroup analysis of night shifts was performed. Analysis of variance and linear regression analysis were performed.
Results: A total of 2950 shifts were identified, including 1328 PGY-1 shifts and 1622 PGY-2 shifts, which involved a total of 32,379 patient encounters. PGY-1 residents saw a mean of 0.88-0.96 PPH on sequential shifts 1-7, respectively ( y -intercept 0.923, slope 0.001, 95% CI -0.008 to 0.009, p  = 0.86). PGY-2 residents saw a mean of 1.61-1.75 PPH on Shifts 1-7, respectively ( y -intercept 1.628, slope 0.004, 95% CI -0.007 to 0.015, p  = 0.50). A subgroup analysis of 598 overnight shifts (11 p.m.-7 a.m.) was performed, in which residents saw a mean of 1.29-1.56 PPH on Sequential Shifts 1-7 ( y -intercept 1.286, slope 0.011, 95% CI -0.011 to 0.033, p  = 0.34).
Conclusions: EM resident productivity remained relatively constant across consecutive shifts, including night shifts. These findings may have educational and operational implications. Further research is required to understand patient- and provider-oriented consequences of consecutive shift scheduling.
Competing Interests: The authors declare no conflicts of interest.
(© 2023 Society for Academic Emergency Medicine.)
Databáze: MEDLINE
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