Association between physician resource utilization, throughput, and patient experience in the emergency department

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Background and Importance: Emergency department (ED) care is complex, involving multifaceted factors such as patient volume, provider experience, throughput metrics, and patient-provider interactions. While some studies have explored relationships between these parameters, there is still much to understand about the nuances in ED care. Objective: Our study aimed to analyze the statistical relationships between admission rates, Press Ganey (PG) scores, and various throughput/resource utilization variables in the ED. These variables include imaging and lab ordering rates, door-to-doctor (D2D) success rate, disposition times for specific patient acuities, and elopement or discharge against medical advice (AMA) rates. Design: A retrospective cohort study was conducted using data from eight emergency facilities within the Valley Health System. Settings and Participants: Data from six community hospital EDs and two freestanding emergency departments (FEDs) in the Valley Health System, spanning August 1, 2020, to July 31, 2021, were examined. The analysis involved 99 physicians and approximately 200,000 adult patients. Outcome Measures and Analysis: Correlations between admission rates, PG scores, and various ED metrics were examined using the Jamovi software. Separate analyses were conducted based on facility type using ANOVAs. Main Results: Our findings revealed several significant correlations. There was a positive correlation between lab ordering and admission rates, while D2D success rates showed a negative correlation with admission rates. Additionally, there was a positive association between D2D success rates and quick dispositioning of lower acuity patients. Patient satisfaction (PG score) was negatively correlated with admission, AMA, and D2D success rates, whereas it positively correlated with lab ordering rates. Conclusion: This study identifies significant relationships among ED throughput, resource utilization, and patient satisfaction metrics. These findings can guide further research to understand the patient experience better, optimize resource utilization, and improve overall ED efficiency.