The impact of medical specialist staffing on emergency department patient flow and satisfaction

van der Linden, MC; de Beaufort, RAY; Meylaerts, SAG; van den Brand, CL; van der Linden, N

The impact of medical specialist staffing on emergency department patient flow and satisfaction

van der Linden, MC de Beaufort, RAY Meylaerts, SAG van den Brand, CL van der Linden, N

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Publisher:: Lippincott, Williams & Wilkins
Publication Type:: Journal Article
Citation:: European Journal of Emergency Medicine, 2019, 26, (1), pp. 47-52
Issue Date:: 2019

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Field	Value	Language
dc.contributor.author	van der Linden, MC
dc.contributor.author	de Beaufort, RAY
dc.contributor.author	Meylaerts, SAG
dc.contributor.author	van den Brand, CL
dc.contributor.author	van der Linden, N
dc.date.accessioned	2020-05-07T02:55:01Z
dc.date.available	2020-05-07T02:55:01Z
dc.date.issued	2019
dc.identifier.citation	European Journal of Emergency Medicine, 2019, 26, (1), pp. 47-52
dc.identifier.issn	0969-9546
dc.identifier.issn	1473-5695
dc.identifier.uri	http://hdl.handle.net/10453/140534
dc.description.abstract	Objective The aim of this study was to describe the impact of additional medical specialists, non-emergency physicians (non-EPs), performing direct supervision or a combination of direct and indirect supervision at an EP-led emergency department (ED), on patient flow and satisfaction. Patients and methods An observational, cross-sectional, three-part study was carried out including staff surveys (n=379), a before and after 16-week data collection using data of visits during the peak hours (n=5270), and patient questionnaires during 1 week before the pilot and during week 5 of the pilot. Content analysis and descriptive statistics were used for analyses. Results The value of being present at the ED was acknowledged by medical specialists in 49% of their surveys and 35% of the EPs’ and ED nurses’ surveys, especially during busy shifts. Radiologists were most often (67.3%) convinced of their value of being on-site, which was agreed upon by the ED professionals. Perceived improved quality of care, shortening of length of stay, and enhanced peer consultation were mentioned most often. During the pilot period, length of stay of boarded patients decreased from 197 min (interquartile range: 121 min) to 181 min (interquartile range: 113 min, P=0.006), and patient recommendation scores increased from −15 to +20. Conclusion Although limited by the mix of direct and indirect supervision, our results suggest a positive impact of additional medical specialists during busy shifts. Throughput of admitted patients and patient satisfaction improved during the pilot period. Whether these findings differ between direct supervision and combination of direct and indirect supervision by the medical specialists requires further investigation.
dc.format	Print
dc.language	en
dc.publisher	Lippincott, Williams & Wilkins
dc.relation.ispartof	European Journal of Emergency Medicine
dc.relation.isbasedon	10.1097/MEJ.0000000000000487
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	1103 Clinical Sciences
dc.subject.classification	Emergency & Critical Care Medicine
dc.subject.mesh	Humans
dc.subject.mesh	Length of Stay
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Medical Staff
dc.subject.mesh	Emergency Service, Hospital
dc.subject.mesh	Patient Satisfaction
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Health Workforce
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Emergency Service, Hospital
dc.subject.mesh	Health Workforce
dc.subject.mesh	Humans
dc.subject.mesh	Length of Stay
dc.subject.mesh	Medical Staff
dc.subject.mesh	Patient Satisfaction
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Surveys and Questionnaires
dc.title	The impact of medical specialist staffing on emergency department patient flow and satisfaction
dc.type	Journal Article
utslib.citation.volume	26
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1103 Clinical Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-05-07T02:54:59Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	26
utslib.start-page	47
utslib.citation.issue	1

Abstract:

Objective The aim of this study was to describe the impact of additional medical specialists, non-emergency physicians (non-EPs), performing direct supervision or a combination of direct and indirect supervision at an EP-led emergency department (ED), on patient flow and satisfaction. Patients and methods An observational, cross-sectional, three-part study was carried out including staff surveys (n=379), a before and after 16-week data collection using data of visits during the peak hours (n=5270), and patient questionnaires during 1 week before the pilot and during week 5 of the pilot. Content analysis and descriptive statistics were used for analyses. Results The value of being present at the ED was acknowledged by medical specialists in 49% of their surveys and 35% of the EPs’ and ED nurses’ surveys, especially during busy shifts. Radiologists were most often (67.3%) convinced of their value of being on-site, which was agreed upon by the ED professionals. Perceived improved quality of care, shortening of length of stay, and enhanced peer consultation were mentioned most often. During the pilot period, length of stay of boarded patients decreased from 197 min (interquartile range: 121 min) to 181 min (interquartile range: 113 min, P=0.006), and patient recommendation scores increased from −15 to +20. Conclusion Although limited by the mix of direct and indirect supervision, our results suggest a positive impact of additional medical specialists during busy shifts. Throughput of admitted patients and patient satisfaction improved during the pilot period. Whether these findings differ between direct supervision and combination of direct and indirect supervision by the medical specialists requires further investigation.

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http://hdl.handle.net/10453/140534