Cargando…

Fast does not imply flawed: Analyzing emergency physician productivity and medical errors

OBJECTIVE: To determine whether emergency physician productivity is associated with the risk of medical errors. METHODS: We retrospectively analyzed quality assurance (QA) and billing data over 3 years at 2 urban emergency departments. Faculty physicians working 400 hours or more at either site were...

Descripción completa

Detalles Bibliográficos
Autores principales: Hoot, Nathan R., Barbosa, Timothy J., Chan, Hei Kit, Rogg, Jonathan G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680560/
https://www.ncbi.nlm.nih.gov/pubmed/36425644
http://dx.doi.org/10.1002/emp2.12849
_version_ 1784834447116337152
author Hoot, Nathan R.
Barbosa, Timothy J.
Chan, Hei Kit
Rogg, Jonathan G.
author_facet Hoot, Nathan R.
Barbosa, Timothy J.
Chan, Hei Kit
Rogg, Jonathan G.
author_sort Hoot, Nathan R.
collection PubMed
description OBJECTIVE: To determine whether emergency physician productivity is associated with the risk of medical errors. METHODS: We retrospectively analyzed quality assurance (QA) and billing data over 3 years at 2 urban emergency departments. Faculty physicians working 400 hours or more at either site were included. We measured physician years of experience, age, gender, patients seen per hour (PPH), and relative value units billed per hour (RVU/h). From an established QA process, we obtained adjudicated medical errors to calculate rates of medical errors per 1000 patients seen as the outcome. We discretized numeric variables and used Kruskal–Wallis testing to examine relationships between independent variables and rates of medical errors. RESULTS: We included data for 39 physicians at site A and 42 at site B. The median rate of errors per 1000 patients was 1.6 (interquartile range [IQR], 1.1–1.9) at site A and 3.3 (IQR, 2.4–3.9) at site B. At site A, RVU/h was associated with error rates (P = 0.03), with medians of 2.0, 1.2, 1.7, and 1.3 errors per 1000 patients, from slowest to fastest quartiles. At site B, PPH was associated with error rates (P < 0.01), with medians of 3.9, 3.7, 2.4, and 2.7 errors per 1000 patients, from slowest to fastest quartiles. There was no significant relationship between error rates and PPH at site A or RVU/h at site B. CONCLUSIONS: Rates of medical errors were associated with 1 metric of physician productivity at each site, with higher error rates seen among physicians with slower productivity.
format Online
Article
Text
id pubmed-9680560
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-96805602022-11-23 Fast does not imply flawed: Analyzing emergency physician productivity and medical errors Hoot, Nathan R. Barbosa, Timothy J. Chan, Hei Kit Rogg, Jonathan G. J Am Coll Emerg Physicians Open The Practice of Emergency Medicine OBJECTIVE: To determine whether emergency physician productivity is associated with the risk of medical errors. METHODS: We retrospectively analyzed quality assurance (QA) and billing data over 3 years at 2 urban emergency departments. Faculty physicians working 400 hours or more at either site were included. We measured physician years of experience, age, gender, patients seen per hour (PPH), and relative value units billed per hour (RVU/h). From an established QA process, we obtained adjudicated medical errors to calculate rates of medical errors per 1000 patients seen as the outcome. We discretized numeric variables and used Kruskal–Wallis testing to examine relationships between independent variables and rates of medical errors. RESULTS: We included data for 39 physicians at site A and 42 at site B. The median rate of errors per 1000 patients was 1.6 (interquartile range [IQR], 1.1–1.9) at site A and 3.3 (IQR, 2.4–3.9) at site B. At site A, RVU/h was associated with error rates (P = 0.03), with medians of 2.0, 1.2, 1.7, and 1.3 errors per 1000 patients, from slowest to fastest quartiles. At site B, PPH was associated with error rates (P < 0.01), with medians of 3.9, 3.7, 2.4, and 2.7 errors per 1000 patients, from slowest to fastest quartiles. There was no significant relationship between error rates and PPH at site A or RVU/h at site B. CONCLUSIONS: Rates of medical errors were associated with 1 metric of physician productivity at each site, with higher error rates seen among physicians with slower productivity. John Wiley and Sons Inc. 2022-11-22 /pmc/articles/PMC9680560/ /pubmed/36425644 http://dx.doi.org/10.1002/emp2.12849 Text en © 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle The Practice of Emergency Medicine
Hoot, Nathan R.
Barbosa, Timothy J.
Chan, Hei Kit
Rogg, Jonathan G.
Fast does not imply flawed: Analyzing emergency physician productivity and medical errors
title Fast does not imply flawed: Analyzing emergency physician productivity and medical errors
title_full Fast does not imply flawed: Analyzing emergency physician productivity and medical errors
title_fullStr Fast does not imply flawed: Analyzing emergency physician productivity and medical errors
title_full_unstemmed Fast does not imply flawed: Analyzing emergency physician productivity and medical errors
title_short Fast does not imply flawed: Analyzing emergency physician productivity and medical errors
title_sort fast does not imply flawed: analyzing emergency physician productivity and medical errors
topic The Practice of Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680560/
https://www.ncbi.nlm.nih.gov/pubmed/36425644
http://dx.doi.org/10.1002/emp2.12849
work_keys_str_mv AT hootnathanr fastdoesnotimplyflawedanalyzingemergencyphysicianproductivityandmedicalerrors
AT barbosatimothyj fastdoesnotimplyflawedanalyzingemergencyphysicianproductivityandmedicalerrors
AT chanheikit fastdoesnotimplyflawedanalyzingemergencyphysicianproductivityandmedicalerrors
AT roggjonathang fastdoesnotimplyflawedanalyzingemergencyphysicianproductivityandmedicalerrors