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Triage physicians in an academic emergency department: Impact on resident education
Author(s) -
Jen Maxwell,
Goubert Ronald,
Toohey Shan,
Zuabi Nadia,
Wray Alisa
Publication year - 2021
Publication title -
aem education and training
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 9
ISSN - 2472-5390
DOI - 10.1002/aet2.10567
Subject(s) - overcrowding , triage , medicine , confidence interval , emergency department , emergency medicine , retrospective cohort study , observational study , medical emergency , nursing , economics , economic growth
Background Overcrowding in emergency departments (EDs) in the United States has been linked to worse patient outcomes. Implementation of countermeasures such as a physician‐in‐triage (PIT) system have improved patient care and decreased wait times. The purpose of this study was to evaluate how a PIT system affects medical resident education in an academic ED. Methods This was a retrospective observational comparison of resident metrics at a single‐site, urban, academic ED before and after implementing a PIT system. Resident metrics of average emergency severity index (ESI), patients‐per‐hour, and in‐training‐examination scores were measured before and six months after the implementation of the PIT system. Results In total, 18,231 patients were evaluated by all residents in the study period before PIT implementation compared to 17,008 in the study period following PIT implementation. The average ESI among patients evaluated by residents decreased from 3.00 to 2.68 (p < 0.01, 95% confidence interval [CI] = 0.31 to 0.33), while average resident patient‐per‐hour rate decreased from 1.41 to 1.32 (p < 0.01, 95% CI = 0.05 to 0.13] and ITE scores saw no statistically significant change of 76.11 to 78.26 (p = 0.26, 95% CI = −5.75 to 1.45). While these differences are statistically significant, they are likely not clinically significant. Conclusions Our implementation of PIT system at one academic medical center minimally increased the acuity and minimally decreased the number of patients that residents see. This suggested that in our center, a PIT program did not detract from ED resident clinical education. However, further research with alternative markers in multiple centers is needed.