TY - JOUR
T1 - Fast does not imply flawed
T2 - Analyzing emergency physician productivity and medical errors
AU - Hoot, Nathan R.
AU - Barbosa, Timothy J.
AU - Chan, Hei Kit
AU - Rogg, Jonathan G.
N1 - Publisher Copyright:
© 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.
PY - 2022/12
Y1 - 2022/12
N2 - Objective: To determine whether emergency physician productivity is associated with the risk of medical errors. Methods: We retrospectively analyzed quality assurance (QA) and billing data over 3 years at 2 urban emergency departments. Faculty physicians working 400 hours or more at either site were included. We measured physician years of experience, age, gender, patients seen per hour (PPH), and relative value units billed per hour (RVU/h). From an established QA process, we obtained adjudicated medical errors to calculate rates of medical errors per 1000 patients seen as the outcome. We discretized numeric variables and used Kruskal–Wallis testing to examine relationships between independent variables and rates of medical errors. Results: We included data for 39 physicians at site A and 42 at site B. The median rate of errors per 1000 patients was 1.6 (interquartile range [IQR], 1.1–1.9) at site A and 3.3 (IQR, 2.4–3.9) at site B. At site A, RVU/h was associated with error rates (P = 0.03), with medians of 2.0, 1.2, 1.7, and 1.3 errors per 1000 patients, from slowest to fastest quartiles. At site B, PPH was associated with error rates (P < 0.01), with medians of 3.9, 3.7, 2.4, and 2.7 errors per 1000 patients, from slowest to fastest quartiles. There was no significant relationship between error rates and PPH at site A or RVU/h at site B. Conclusions: Rates of medical errors were associated with 1 metric of physician productivity at each site, with higher error rates seen among physicians with slower productivity.
AB - Objective: To determine whether emergency physician productivity is associated with the risk of medical errors. Methods: We retrospectively analyzed quality assurance (QA) and billing data over 3 years at 2 urban emergency departments. Faculty physicians working 400 hours or more at either site were included. We measured physician years of experience, age, gender, patients seen per hour (PPH), and relative value units billed per hour (RVU/h). From an established QA process, we obtained adjudicated medical errors to calculate rates of medical errors per 1000 patients seen as the outcome. We discretized numeric variables and used Kruskal–Wallis testing to examine relationships between independent variables and rates of medical errors. Results: We included data for 39 physicians at site A and 42 at site B. The median rate of errors per 1000 patients was 1.6 (interquartile range [IQR], 1.1–1.9) at site A and 3.3 (IQR, 2.4–3.9) at site B. At site A, RVU/h was associated with error rates (P = 0.03), with medians of 2.0, 1.2, 1.7, and 1.3 errors per 1000 patients, from slowest to fastest quartiles. At site B, PPH was associated with error rates (P < 0.01), with medians of 3.9, 3.7, 2.4, and 2.7 errors per 1000 patients, from slowest to fastest quartiles. There was no significant relationship between error rates and PPH at site A or RVU/h at site B. Conclusions: Rates of medical errors were associated with 1 metric of physician productivity at each site, with higher error rates seen among physicians with slower productivity.
KW - Efficiency
KW - Emergency Medicine
KW - Medical Errors
KW - Patient Safety
KW - Workload
UR - http://www.scopus.com/inward/record.url?scp=85144967851&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85144967851&partnerID=8YFLogxK
U2 - 10.1002/emp2.12849
DO - 10.1002/emp2.12849
M3 - Article
AN - SCOPUS:85144967851
SN - 2688-1152
VL - 3
JO - Journal of the American College of Emergency Physicians Open
JF - Journal of the American College of Emergency Physicians Open
IS - 6
M1 - e12849
ER -