1887
Volume 2021, Issue 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

The time to initial physician contact or time for medical doctor (tMD) is one of the crucial key performance indicators for the emergency department (ED). The “tMD” helps in improving medical care, administrative benefits, and operational changes. The main aim of this study was to assess the effects of different operational changes on tMD. The study was a prospectively designed analysis for one year. Data were collected via the study center's electronic records. The study was divided into three operational events (increase in number of consultants, change of shift timings, and increase in consultants covering a shift) in comparison with the baseline (prestudy) period. Data were then downloaded and imported into the statistical software package Stata for a detailed analysis. The study commenced on July 1, 2016, with a 52-week period and 418,899 patient encounters. The coefficient for tMD slope improvement as compared with baseline with confidence interval (CI) and value was: Phase 1: −2.5 [CI: −4.1 to −0.97 ( = 0.002)]; Phase 2: −1.6 [CI: −2.8 to −0.37 ( = 0.031)]; and Phase 3: −2.4 [CI: −3.4 to −1.4 ( < 0.001)]. The study phases showed a significant improvement over the baseline study period. The study results indicate that different types of interventions (e.g.,., changing shift times, increasing total hours of MD coverage throughout the day) had demonstrated different apparent effects in this study's ED. Further work in this study's ED should aim to continue to reduce absolute tMD and decrease variation by homogenizing dispersion as much as possible across the 24 hours of a day. ED has no control over the concentration or spread of visitors over the period of the day. The data were useful for guiding operations planning both during the study period and thereafter, as operations continue to focus on optimizing tMD.

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2021-06-24
2021-08-04
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