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The Effect of Emergency Medicine Residents on Clinical Efficiency and Staffing Requirements
Author(s) -
Clinkscales Jeffrey D.,
Fesmire Francis M.,
Hennings Jacob R.,
Severance Harry W.,
Seaberg David C.,
Patil Nirav
Publication year - 2016
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12834
Subject(s) - staffing , medicine , emergency department , emergency physician , emergency medicine , residency training , observational study , family medicine , medical emergency , nursing , continuing education , medical education
Abstract Objectives The effect of emergency medicine ( EM ) residents on the clinical efficiency of attending physicians is controversial. The authors hypothesized that implementing a new EM residency program would result in an increase in relative value units ( RVU s) generated per hour by attending physicians and decrease staffing requirements. Methods This was a retrospective observational analysis of an emergency department before, during, and after the establishment of a new EM residency program. We analyzed the change in RVU s billed, patients seen, and hours worked by attending physicians, midlevel providers ( MLP s), and residents, and addressed potential confounding factors. Results The clinical efficiency of attending physicians increased by 70%, or 4.98 RVU s/hour (from 7.12 [ SD ± 1.4] RVU s/hour to 12.1 [ SD ± 2.2] RVU s/hour, p < 0.001) with the implementation of an EM residency program. Overall, net department RVU generation rose by 32%, even as attending physician coverage decreased by 6.3% (p < 0.05), and MLP coverage dropped by 60% (p < 0.05). We estimated that the implementation of the residency saved 4,860 hours of attending physician coverage and 5,828 hours of MLP coverage per year. This represents an estimated $1,741,265 in annual staffing savings, comparable to the residency program's annual operating cost of $1,821,108. Conclusions The implementation of an EM residency program had a positive effect on the clinical efficiency of attending physicians and decreased staffing requirements.