@article{hbkup:/content/journals/10.5339/qmj.2020.7, author = "Jenkins, Dominic and Pathan, Sameer and Moinudheen, Jibin and Qureshi, Raheel and Qureshi, Isma and Farook, Saleem and Thomas, Stephen", title = "The Impact of On-duty Emergency Medicine Trainees on Left-Without-Being-Seen Rates in an Academic Emergency Department", journal= "Qatar Medical Journal", year = "2020", volume = "2020", number = "1", pages = "", doi = "https://doi.org/10.5339/qmj.2020.7", url = "https://www.qscience.com/content/journals/10.5339/qmj.2020.7", publisher = "Hamad bin Khalifa University Press (HBKU Press)", issn = "2227-0426", type = "Journal Article", keywords = "Left-Without-Being-Seen", keywords = "Emergency Department", keywords = "LWBS", keywords = "ED Key performance Indicators", keywords = "Emergency Medicine operations", keywords = "EM Trainees", eid = "7", abstract = "Objectives: One of the endpoints for assessing the emergency department (ED) performance is the left-without-being-seen (LWBS) proportion. This study aimed to evaluate the impact of increasing proportions of on-duty emergency medicine (EM) trainees on LWBS rates in clinical shifts. Methods: The study was conducted at an urban-academic-ED (annual census: 452,757) over a period of one year. We employed multivariate linear regression (p < 0.05) defining significance to identify and adjust for multiple LWBS influencers related to patient care. Results: After analyzing over 1098 shifts, the median LWBS rate was 8.9% (interquartile range 5.3% to 13.5%). The increasing number of EM trainees in the ED did not adversely impact the LWBS; the opposite was noted. In univariate analysis, the increasing proportion of on-duty EM trainee physicians was significantly (p < 0.001) associated with a decrease in the LWBS rates. The multivariate model adjusted for the statistically significant and confounding LWBS influencers, with an absolute increase of 1% in trainees’ proportion of overall on-duty physician coverage, was associated with an absolute decrease of 2.1% in LWBS rates (95% confidence interval 0.43% to 3.8%, p = 0.014). Conclusions: At the study site, there was a statistically and operationally significant improvement in LWBS associated with partial replacement of board-certified specialist-grade EM physicians with EM residents and fellow trainees.", }