Key High-efficiency Practices of Emergency Department Providers: A Mixed-methods Study

Area of Science:

• Emergency Medicine
• Healthcare Management
• Clinical Operations

Background:

• Optimizing provider efficiency in community emergency departments (EDs) is crucial for effective patient care and resource allocation.
• Understanding specific provider practices that correlate with high efficiency can inform operational improvements.

Purpose of the Study:

• To identify and analyze provider practices associated with high efficiency in community emergency departments.
• To provide actionable insights for improving provider productivity and workflow.

Main Methods:

• A mixed-methods approach combining semistructured interviews with an observational study.
• Data collection involved 16 participants for behavior identification and 35 providers observed in four community EDs.
• Statistical analysis used generalized estimating equations to test associations between practices and efficiency (relative value units/hour).

Main Results:

• Five practices positively correlated with provider efficiency: average patient load, using team members' names, team conversations, patient room visits, and "running the board."
• Two "inefficiency practices" showed negative correlations: non-work-related tasks and documenting on patients no longer in the ED.

Conclusions:

• Practices such as managing patient load, team communication, and active board management enhance provider productivity.
• These identified behaviors offer a framework for medical directors, clinicians, and trainees to improve personal efficiency and team performance.