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The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department

Objectives: One of the endpoints for assessing the emergency department (ED) performance is the left-without-being-seen (LWBS) proportion. This study aimed to evaluate the impact of increasing proportions of on-duty emergency medicine (EM) trainees on LWBS rates in clinical shifts. Methods: The stud...

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Detalles Bibliográficos
Autores principales: Jenkins, Dominic, Pathan, Sameer, Moinudheen, Jibin, Qureshi, Raheel, Qureshi, Isma, Farook, Saleem, Thomas, Stephen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: HBKU Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7109545/
https://www.ncbi.nlm.nih.gov/pubmed/32257881
http://dx.doi.org/10.5339/qmj.2020.7
Descripción
Sumario:Objectives: One of the endpoints for assessing the emergency department (ED) performance is the left-without-being-seen (LWBS) proportion. This study aimed to evaluate the impact of increasing proportions of on-duty emergency medicine (EM) trainees on LWBS rates in clinical shifts. Methods: The study was conducted at an urban-academic-ED (annual census: 452,757) over a period of one year. We employed multivariate linear regression (p < 0.05) defining significance to identify and adjust for multiple LWBS influencers related to patient care. Results: After analyzing over 1098 shifts, the median LWBS rate was 8.9% (interquartile range 5.3% to 13.5%). The increasing number of EM trainees in the ED did not adversely impact the LWBS; the opposite was noted. In univariate analysis, the increasing proportion of on-duty EM trainee physicians was significantly (p < 0.001) associated with a decrease in the LWBS rates. The multivariate model adjusted for the statistically significant and confounding LWBS influencers, with an absolute increase of 1% in trainees’ proportion of overall on-duty physician coverage, was associated with an absolute decrease of 2.1% in LWBS rates (95% confidence interval 0.43% to 3.8%, p = 0.014). Conclusions: At the study site, there was a statistically and operationally significant improvement in LWBS associated with partial replacement of board-certified specialist-grade EM physicians with EM residents and fellow trainees.