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Reducing length of stay and satisfying learner needs
Lisa Shepherd1, Saad Chahine2, Michelle Klingel3
1Centre for Education Research and Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. lshepher@uwo.ca.
Perspectives on Medical Education
|June 2, 2016
Summary
Dedicated teaching shifts in the emergency department (ED) improved patient flow by reducing length of stay. This educational intervention also enhanced medical learners' self-efficacy and knowledge application skills.
Area of Science:
- Medical Education
- Emergency Medicine
- Healthcare Management
Background:
- The emergency department (ED) faces challenges balancing learner education with efficient patient flow.
- Traditional ED rotations can create conflicts between teaching needs and patient care demands.
Purpose of the Study:
- To investigate the impact of dedicated teaching shifts on ED patient length of stay.
- To assess the effect of these shifts on medical learners' self-efficacy and knowledge application.
Main Methods:
- A prospective cohort study involving 132 clinical clerks in a Canadian acute-care teaching center.
- Implementation of three supervised teaching shifts without direct patient care responsibilities, followed by traditional clinical shifts.
- Assessment of ED length of stay, validated self-efficacy questionnaires, and pre/post knowledge application case activities.
Main Results:
- Overall median ED length of stay decreased by 5 minutes across 40,998 patient visits.
- A significant reduction of 20 minutes in median length of stay was observed during the initial academic block.
- Learners showed significant improvements in self-efficacy (p < 0.001) and knowledge application (p < 0.01), particularly in generating differential diagnoses.
Conclusions:
- Dedicated teaching shifts represent an effective educational strategy in the ED.
- This intervention positively influences ED patient flow and addresses learner educational needs.
- Early academic blocks benefit most from teaching shifts, maximizing improvements in ED length of stay.
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