EFFECT OF THE INTRODUCTION OF EMERGENCY MEDICINE SPECIALISTS ON THE EMERGENCY DEPARTMENT PERFORMANCE INDICATORS: A RETROSPECTIVE DATA ANALYSIS.

Abstract

SUMMARYPatient management in the emergency department (ED) is evaluated by performance indicators, such as wait times (time to be seen by a physician), length of stay (LOS) and the number of diagnostic tests per patient. To improve the quality of care, dedicated emergency medicine (EM) specialists are employed to work in the ED. The aim of this study is to evaluate three performance indicators of patient management in the ED compared by specialty, internal medicine (IM) versus EM. Research was conducted in the ED of a large tertiary teaching hospital. A retrospective data analysis of the hospital information system was conducted for the period when only IM specialists were working as attendants, versus a period when two EM specialists joined the ED team. We calculated the percentage of patients seen within the recommended time per Australasian Triage system (AST) category and compared the average LOS and the average number of tests per patient, using data from June 2017 to January 2020. Means, standard deviation, standard error, 95% confidence interval were calculated, and the independent t-test was used to compare means. With the introduction of the EM specialists, the percentage of patients examined within the recommended time frame per AST category was higher. There was a significant reduction in LOS in the ED when comparing only IM specialists to IM specialists with two EM specialists (p<0.001). The IM physicians on average do more tests than EM specialists, which was statistically significant (p<0.05). There was a significant improvement in efficiency in the ED with the introduction of EM specialists which was manifested by shorter patient wait times and shorter length of stay in the Emergency Department and fewer diagnostic test orders.