Changes in Resident Coverage and its Effect on Emergency Department Metrics at a Community Hospital Emergency Department

Introduction: The training of resident physicians is vital to the future of Emergency Medicine. This study investigates whether schedule changes initiated by residents at a community Emergency Department (ED) affect ED metrics.

Methods: This study employed a retrospective cohort design. Data was collected from a community emergency department that trains emergency medicine residents. We compared the eight weeks prior to and after the changes in resident hours to determine if the emergency department's metrics were influenced. The metrics examined included daily census, left without treatment (LWOT) rate, emergency department (ED) length of stay (LOS), ED arrival to ED rooming time, and ED arrival to ED disposition time.

Results: Statistical significance was noted for improvements in both LWOT and ED LOS averages. The ED LOS average decreased from 278.5 minutes to 257 minutes. Both total ED LOS and arrival to room showed a p-value of 0.06, nearing statistical significance. The metrics that remained unchanged were the ED visit count and the time from ED arrival to disposition.

Discussion: Adjustments to resident hours improved ED LOS and (LWOT). The other metrics were not impacted.

Conclusion: This study advocates for resident-driven changes to emergency department schedules that do not negatively affect ED metrics and may even enhance them in some instances.