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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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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
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author Jenkins, Dominic
Pathan, Sameer
Moinudheen, Jibin
Qureshi, Raheel
Qureshi, Isma
Farook, Saleem
Thomas, Stephen
author_facet Jenkins, Dominic
Pathan, Sameer
Moinudheen, Jibin
Qureshi, Raheel
Qureshi, Isma
Farook, Saleem
Thomas, Stephen
author_sort Jenkins, Dominic
collection PubMed
description 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.
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spelling pubmed-71095452020-04-03 The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department Jenkins, Dominic Pathan, Sameer Moinudheen, Jibin Qureshi, Raheel Qureshi, Isma Farook, Saleem Thomas, Stephen Qatar Med J Research Article 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. HBKU Press 2020-04-01 /pmc/articles/PMC7109545/ /pubmed/32257881 http://dx.doi.org/10.5339/qmj.2020.7 Text en © 2020 Jenkins, Pathan, Moinudheen, Qureshi, Qureshi, Farook, Thomas, licensee HBKU Press. This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Jenkins, Dominic
Pathan, Sameer
Moinudheen, Jibin
Qureshi, Raheel
Qureshi, Isma
Farook, Saleem
Thomas, Stephen
The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department
title The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department
title_full The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department
title_fullStr The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department
title_full_unstemmed The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department
title_short The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department
title_sort impact of on-duty emergency medicine trainees on left-without-being-seen rates in an academic emergency department
topic Research Article
url 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
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