Abstract
Background
Differences in productivity between off-service residents rotating in the emergency
department (ED) and their emergency medicine (EM) resident counterparts have never
been directly quantified.
Objectives
We sought to quantify the difference between off-service residents rotating in the
ED and their EM resident counterparts. We also sought to find whether shift cards
could be used to increase the productivity of off-service residents rotating in the
ED.
Methods
This is a prospective cohort study conducted at an urban, tertiary, Level I trauma
center. We implemented the use of shift cards for off-service residents during their
EM rotation. Completion of the shift card involved recording patients seen and their
dispositions, procedures done, and documenting a learned bedside teaching point from
their shift that day. Productivity was measured in terms of patients seen per hour
(PPH) and relative value units per hour (RVU/h).
Results
Off-service residents showed a productivity of 0.529 PPH (95% confidence interval
[CI] 0.493–0.566) and 1.40 RVU/h (95% CI 1.28–1.53) prior to implementation of shift
cards. With the introduction of shift cards, productivity increased to 0.623 PPH (95%
CI 0.584–0.663, p = 0.001) and 1.77 RVU/h (95% CI 1.64–1.91, p = 0.001). In comparison, first year EM resident productivity was 0.970 PPH (95% CI
0.918–1.02) and 3.01 RVU/h (95% CI 2.83–3.19).
Conclusions
Shift cards can be used to foster motivation for off-service residents rotating in
the ED, and is a simple and cost-effective method to improve system-based practices
and utilization of resources.
Keywords
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Article info
Publication history
Published online: January 21, 2015
Accepted:
November 10,
2014
Received in revised form:
August 15,
2014
Received:
December 17,
2013
Footnotes
Institutional Review Board approved: University of California, Irvine Office of Research; approval obtained December 11, 2013.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
