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Related Experiment Videos

Coping with a crowded ED: an expanded unique role for midlevel providers.

Soumya Ganapathy1, Frank L Zwemer

  • 1Department of Emergency Medicine, University of Rochester, Strong Memorial Hospital, Rochester, NY, USA.

The American Journal of Emergency Medicine
|April 3, 2003
PubMed
Summary

A transition team of midlevel practitioners (MLPs) managed patients awaiting inpatient beds, reducing emergency department (ED) physician workload but not improving patient satisfaction. This team offers a potential staffing solution for crowded EDs.

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Area of Science:

  • Emergency Medicine
  • Healthcare Management
  • Clinical Operations

Background:

  • Emergency department (ED) crowding is a significant issue.
  • Causes include space and staffing limitations in both EDs and inpatient areas.
  • Waiting for inpatient beds is a primary driver of ED crowding.

Purpose of the Study:

  • To evaluate a novel managerial strategy for ED crowding.
  • To assess the impact of a transition team (TT) on emergency medicine (EM) physician workload.
  • To determine the effect of the TT on patient satisfaction and care.

Main Methods:

  • A transition team (TT) comprising midlevel practitioners (MLPs) and nurses was formed.
  • The TT managed patients awaiting inpatient beds after initial EM physician evaluation.

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  • Care was transferred to the TT until patients were admitted or left the ED.

    • Main Results:

    • The TT assumed a significant patient load, indicating reduced EM physician workload.
    • Patient satisfaction did not improve with the implementation of the TT.
    • The TT role was perceived as less desirable by MLPs compared to traditional roles.

    Conclusions:

    • The transition team effectively reduced EM physician workload for patients awaiting beds.
    • While not improving patient satisfaction, the TT represents a viable staffing resource for crowded EDs.
    • The desirability of the TT role for MLPs may require further consideration for sustainability.