To Batch or Not to Batch? Impact of Admission Batching on Emergency Department Boarding Time and Physician Productivity

2021 ◽  
Author(s):  
Arshya Feizi ◽  
Anita Tucker ◽  
Jillian Berry Jaeker ◽  
William Baker
Keyword(s):  
Emergency Department ◽  
Physician Productivity

scholarly journals Implementation of electronic charting is not associated with significant change in physician productivity in an academic emergency department

JAMIA Open ◽  
2018 ◽  
Vol 1 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Dusadee Sarangarm ◽  
Gregory Lamb ◽  
Steven Weiss ◽  
Amy Ernst ◽  
Lorraine Hewitt
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Productivity Index ◽  
Full Time ◽  
Full Time Equivalent ◽  
Physician Productivity ◽  
Relative Value ◽  
Before And After ◽  
Study Implementation ◽  
Total Productivity

Abstract Objectives To compare physician productivity and billing before and after implementation of electronic charting in an academic emergency department (ED). Materials and methods This retrospective, blinded, observational study compared the 6 months pre-implementation (January to June 2012) with the 6 months post-implementation 1 year later (January to June 2013). Thirty-one ED physicians were recruited, with each physician acting as his/her own control in a before-after design. Productivity was measured via total number of encounters and “productivity index” defined as worked relative value units divided by the clinical full-time equivalent. Values for charges, encounters, and productivity index were determined during each study period and separately for procedures, observational stays, and critical care. Results No differences were found for total productivity index per month (758 [623-876] pre-group vs. 756 [673-886] post-group; P = 0.30). There was, however, a 9% decrease in total encounters per month (138 [101-163] pre-group vs. 125 [99-159] post-group; P = 0.01). Significant decreases were seen across all observation stay categories. Conversely, significant increases were seen across all critical care categories. There was no difference in total charges per month. Discussion This is one of few studies to demonstrate minimal disruption in physician productivity after transitioning to electronic documentation. The reasons for these findings are likely multi-factorial. Conclusion In this study, implementation of electronic charting was not associated with decreases in productivity or billing for total ED care, but may be associated with increases for critical care and decreases for observational stays.

Modelling Waiting Times in an Emergency Department in Greece During the Economic Crisis

2018 ◽  
Vol 20 (4) ◽  
pp. 475-485 ◽  
Author(s):  
Panagiotis Manolitzas ◽  
Neophytos Stylianou
Keyword(s):  
Emergency Department ◽  
Economic Crisis ◽  
Emergency Departments ◽  
Waiting Times ◽  
Patient Dissatisfaction ◽  
Department Of Health ◽  
Physician Productivity ◽  
Pain And Suffering ◽  
Prolonged Pain ◽  
Improve Health

Overcrowding is one of the most common phenomenon at the emergency departments of the hospitals across the world. The aforementioned phenomenon causes many problems such as long waiting times for patients, increasing length of stay, patient dissatisfaction, ambulance diversions in some cities, prolonged pain and suffering, violence and miscommunication between the medical staff and the patients, patients leaving the emergency department without been seen and decreased physician productivity. This article analyses the problem of the increased waiting times in a Greek emergency department during the economic crisis. We use statistical models in order to reveal the factors that can lead to a decrease in waiting times. Our findings suggest that Greece’s Department of Health should standardize an uppermost waiting time for emergency departments which could help improve health care.

scholarly journals An attending physician float shift for the improvement of physician productivity in a crowded emergency department

2013 ◽  
Vol 4 (1) ◽  
pp. 10 ◽  
Author(s):  
Muhammad Umer Nasim ◽  
Chintan Mistry ◽  
Robert Harwood ◽  
Erik Kulstad ◽  
Laura Tommaso
Keyword(s):  
Emergency Department ◽  
Physician Productivity ◽  
Attending Physician

scholarly journals Effects of medical scribes on physician productivity in a Canadian emergency department: a pilot study

CMAJ Open ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. E360-E364 ◽  
Author(s):  
Peter S. Graves ◽  
Stephen R. Graves ◽  
Tanvir Minhas ◽  
Rebecca E. Lewinson ◽  
Isabelle A. Vallerand ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Physician Productivity ◽  
Medical Scribes

Impact of a scribe program on patient throughput, physician productivity, and patient satisfaction in a community-based emergency department

2017 ◽  
Vol 25 (1) ◽  
pp. 216-224 ◽  
Author(s):  
Waqas Shuaib ◽  
John Hilmi ◽  
Joshua Caballero ◽  
Ijaz Rashid ◽  
Hashim Stanazai ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Prospective Trial ◽  
Secondary Outcome ◽  
Patient Throughput ◽  
Time Motion ◽  
Physician Productivity ◽  
Relative Value ◽  
Quasi Experimental ◽  
The Impact

Previous literature on the impact of scribe programs varies and has mostly been reported from academic institutions or other clinics. We report the implementation of the scribe program in the emergency room of a community hospital and its impact on patient throughput, physician productivity, and patient satisfaction. We performed a quasi-experimental, before-and-after study measuring patient throughput metrics, physician productivity, and patient satisfaction. The intervention measuring the scribe implementation was divided into pre- and post-implementation periods. Patient throughput metrics were (1) door-to-room time, (2) room-to-doc time, (3) door-to-doc time, (4) doc-to-disposition time, and (5) length of stay for discharged/admitted patients. Our secondary outcome was physician productivity, which was calculated by measuring total patients seen per hour and work relative value units per hour. Additionally, we calculated the time-motion analysis in minutes to measure the emergency department physician’s efficiency by recording the following: (1) chart preparation, (2) chart review, (3) doctor–patient interaction, (4) physical examination, and (5) post-visit documentation. Finally, we measured patient satisfaction as provided by Press Ganey surveys. Data analysis was conducted in 12,721 patient encounters in the pre-scribe cohort, and 13,598 patient encounters in the post-scribe cohort. All the patient throughput metrics were statistically significant (p < 0.0001). The patients per hour increased from 2.3 ± 0.3 pre-scribe to 3.2 ± 0.6 post-scribe cohorts (p < 0.001). Total work relative value units per hour increased from 241(3.1 ± 1.5 per hour) pre-scribe cohort to 336 (5.2 ± 1.4 per hour) post-scribe cohort (p < 0.001). The pre-scribe patient satisfaction was high and remained high in the post-scribe cohort. There was a significant increase in the clinician providing satisfactory feedback from the pre-scribe (3.9 ± 0.3) to the post-scribe (4.7 ± 0.1) cohorts (p < 0.01). We describe a prospective trial of medical scribe use in the emergency department setting to improve patient throughput, physician productivity, and patient satisfaction. We illustrate that scribe use in community emergency department is feasible and results in improvement in all three metrics

Scribes in an Australian private emergency department: A description of physician productivity

2014 ◽  
Vol 26 (6) ◽  
pp. 543-548 ◽  
Author(s):  
Katherine Walker ◽  
Michael Ben-Meir ◽  
Phebe O'Mullane ◽  
David Phillips ◽  
Margaret Staples
Keyword(s):  
Emergency Department ◽  
Physician Productivity

scholarly journals Developing emergency department physician shift schedules optimized to meet patient demand

CJEM ◽  
2015 ◽  
Vol 17 (1) ◽  
pp. 3-12 ◽  
Author(s):  
David W. Savage ◽  
Douglas G. Woolford ◽  
Bruce Weaver ◽  
David Wood
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Fast Track ◽  
Additive Models ◽  
Emergency Department Physician ◽  
Planning Model ◽  
Physician Productivity ◽  
Number Of Patients ◽  
Patient Arrival ◽  
Shift Schedules

AbstractObjectives: 1) To assess temporal patterns in historical patient arrival rates in an emergency department (ED) to determine the appropriate number of shift schedules in an acute care area and a fast-track clinic and 2) to determine whether physician scheduling can be improved by aligning physician productivity with patient arrivals using an optimization planning model.Methods: Historical data were statistically analyzed to determine whether the number of patients arriving at the ED varied by weekday, weekend, or holiday weekend. Poisson-based generalized additive models were used to develop models of patient arrival rate throughout the day. A mathematical programming model was used to produce an optimal ED shift schedule for the estimated patient arrival rates. We compared the current physician schedule to three other scheduling scenarios: 1) a revised schedule produced by the planning model, 2) the revised schedule with an additional acute care physician, and 3) the revised schedule with an additional fast-track clinic physician.Results: Statistical modelling found that patient arrival rates were different for acute care versus fast-track clinics; the patterns in arrivals followed essentially the same daily pattern in the acute care area; and arrival patterns differed on weekdays versus weekends in the fast-track clinic. The planning model reduced the unmet patient demand (i.e., the average number of patients arriving at the ED beyond the average physician productivity) by 19%, 39%, and 69% for the three scenarios examined.Conclusions: The planning model improved the shift schedules by aligning physician productivity with patient arrivals at the ED.

scholarly journals Modelling attending physician productivity in the emergency department: a multicentre study

2018 ◽  
pp. emermed-2017-207194 ◽  
Author(s):  
Joshua W Joseph ◽  
Samuel Davis ◽  
Elissa H Wilker ◽  
Matthew L Wong ◽  
Ori Litvak ◽  
...  
Keyword(s):  
Emergency Department ◽  
Multicentre Study ◽  
Physician Productivity ◽  
Attending Physician
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