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Resident efficiency in a pediatric emergency department
M Denise Dowd1, Celeste Tarantino, Theodore M Barnett
1Division of Emergency Medical Services, Children's Mercy Hospital, Kansas City, MO 64108, USA. ddowd@cmh.edu
Summary
Resident physicians in pediatric emergency departments see more patients per hour as they advance in training and by specialty. Emergency medicine residents had the highest patient evaluation rate, while PGY3 residents saw the most patients hourly.
Area of Science:
- Pediatric Emergency Medicine
- Medical Education
- Healthcare Operations
Background:
- Assessing resident physician efficiency is crucial for academic pediatric emergency departments (PEDs).
- Understanding patient evaluation and treatment rates informs performance metrics and program evaluation.
Purpose of the Study:
- To quantify the hourly patient encounter rate for resident physicians in an academic PED.
- To analyze variations in these rates based on resident subspecialty and postgraduate year.
Main Methods:
- Utilized the EmSTAT electronic tracking system to calculate patient-per-hour (pph) rates for residents in calendar year 2000.
- Collected data from all residents rotating through an urban children's hospital PED.
- Employed analysis of variance (ANOVA) with Tukey's post hoc analysis for statistical comparisons.
Main Results:
- A total of 153 residents evaluated 24,414 patients, with an overall mean rate of 1.02 pph.
- Emergency medicine residents (1.12 pph) saw significantly more patients per hour than pediatrics (1.02 pph) and family practice residents (0.93 pph).
- Patient encounter rates increased with training level, from 0.95 pph for PGY1 to 1.09 pph for PGY3 residents.
Conclusions:
- Significant disparities in patient evaluation and treatment rates exist among resident physicians based on their subspecialty and year of training.
- These findings provide valuable benchmarks for evaluating resident performance and assessing patient exposure within residency programs.