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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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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 |
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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 |
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