Impact of Trainees on Length of Stay in the Emergency Department at an Academic Medical Center
| Autor: | Erin Dehon, McLemore G, McKenzie Lk |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Students Medical Time Factors Nurse practitioners Hospitals University Hospitals Urban medicine Humans Nurse Practitioners Quality of care Retrospective Studies business.industry Trauma center Electronic medical record Internship and Residency General Medicine Overcrowding Emergency department Length of Stay Test (assessment) Family medicine Emergency medicine Emergency Medicine Workforce University teaching Emergency Service Hospital business |
| Zdroj: | Southern Medical Journal. 108:245-248 |
| ISSN: | 0038-4348 |
| DOI: | 10.14423/smj.0000000000000264 |
| Popis: | OBJECTIVES Emergency department (ED) overcrowding remains a growing concern despite continued efforts by hospitals to improve efficiency while also maintaining quality of care and medical education. The purpose of this study was to examine whether the total number of trainees rotating in the ED affects length of stay (LOS). METHODS This was a single-center study conducted at an urban university teaching hospital and level I trauma center that averages 65,000 adult ED visits per year. Data were collected retrospectively during a 13-month period from September 2012 to September 2013. The mean daily LOS was generated by the hospital's electronic medical record system, and the total number of trainees (medical students, postgraduate year-1 students/interns, and nurse practitioners) rotating in the ED each day was collected from monthly shift calendars. Correlations were used to examine the relation between LOS and number of trainees rotating in the ED. Independent sample t tests were conducted to compare differences in average LOS on days with and without trainees rotating in the ED. RESULTS The mean daily LOS ranged from 3.39 to 7.13 hours (mean 4.97, standard deviation [SD] 0.59). The number of trainees rotating in the ED each day ranged from 0 to 11 (mean 5.32, SD 2.39). No significant relation was found between LOS and the number of trainees rotating in the ED (r = 0.06). Subsequent analyses using independent sample t test revealed that LOS did not vary even when no trainees were rotating in the ED (mean 4.93, SD 0.69) versus when at least one trainee was working (mean 4.97, SD 0.59). CONCLUSIONS Findings from this study suggest that ED LOS is unaffected by the presence or total number of trainees (medical students, postgraduate year-1 students/interns, and nurse practitioners) rotating in the ED. Further research is needed to examine what, if any, adjustments are being made to accommodate trainees and whether the quality of education suffers when the trainee-to-attending ratio is high. |
| Databáze: | OpenAIRE |
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