Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys
Abstract Background Academic and non-academic emergency departments (EDs) are regularly compared in clinical operations benchmarking despite suggestion that the two groups may differ in their clinical operations characteristics. and outcomes. We sought to describe and compare clinical operations cha...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12873-019-0285-7 |
| _version_ | 1819295364039049216 |
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| author | Martin A. Reznek Sean S. Michael Cathi A. Harbertson James J. Scheulen James J. Augustine |
| author_facet | Martin A. Reznek Sean S. Michael Cathi A. Harbertson James J. Scheulen James J. Augustine |
| author_sort | Martin A. Reznek |
| collection | DOAJ |
| description | Abstract Background Academic and non-academic emergency departments (EDs) are regularly compared in clinical operations benchmarking despite suggestion that the two groups may differ in their clinical operations characteristics. and outcomes. We sought to describe and compare clinical operations characteristics of academic versus non-academic EDs. Methods We performed a descriptive, comparative analysis of academic and non-academic adult and general EDs with 40,000+ annual encounters, using the Academy of Academic Administrators of Emergency Medicine (AAAEM)/Association of Academic Chairs of Emergency Medicine (AACEM) and Emergency Department Benchmarking Alliance (EDBA) survey results. We defined academic EDs as primary teaching sites for emergency medicine (EM) residencies and non-academic EDs as sites with minimal resident involvement. We constructed the academic and non-academic cohorts from the AAAEM/AACEM and EDBA surveys, respectively, and analyzed metrics common to both surveys. Results Eighty and 454 EDs met inclusion criteria for academic and non-academic EDs, respectively. Academic EDs had more median annual patient encounters (73,001 vs 54,393), lower median proportion of pediatric patients (6.3% vs 14.5%), higher median proportion of EMS patients (27% vs 19%), and were more commonly designated as Level I or II Trauma Centers (94% vs 24%). Median patient arrival-to-provider times did not differ (26 vs 25 min). Median length-of-stay was longer (277 vs 190 min) for academic EDs, and left-before-treatment-complete was higher (5.7% vs 2.9%). MRI utilization was higher for academic EDs (2.2% patients with at least one MRI vs 1.0 MRIs performed per 100 patients). Patients-per-hour of provider coverage was lower for academic EDs with and without consideration for advanced practice providers and residents. Conclusions Demographic and operational performance measures differ between academic and non-academic EDs, suggesting that the two groups may be inappropriate operational performance comparators. Causes for the differences remain unclear but the differences appear not to be attributed solely to the academic mission. |
| first_indexed | 2024-12-24T04:41:02Z |
| format | Article |
| id | doaj.art-75a5011024ae4d5b92ea4eff31655438 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-24T04:41:02Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-75a5011024ae4d5b92ea4eff316554382022-12-21T17:14:49ZengBMCBMC Emergency Medicine1471-227X2019-11-0119111210.1186/s12873-019-0285-7Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveysMartin A. Reznek0Sean S. Michael1Cathi A. Harbertson2James J. Scheulen3James J. Augustine4Department of Emergency Medicine, University of Massachusetts Medical School Worcester Massachusetts 55 Lake Avenue NorthDepartment of Emergency Medicine, University of Colorado School of MedicineDepartment of Emergency Medicine, the Johns Hopkins University School of MedicineDepartment of Emergency Medicine, the Johns Hopkins University School of MedicineDepartment of Emergency Medicine, Wright State University Boonshoft School of Medicin Dayton Ohio USA and US Acute Care SolutionsAbstract Background Academic and non-academic emergency departments (EDs) are regularly compared in clinical operations benchmarking despite suggestion that the two groups may differ in their clinical operations characteristics. and outcomes. We sought to describe and compare clinical operations characteristics of academic versus non-academic EDs. Methods We performed a descriptive, comparative analysis of academic and non-academic adult and general EDs with 40,000+ annual encounters, using the Academy of Academic Administrators of Emergency Medicine (AAAEM)/Association of Academic Chairs of Emergency Medicine (AACEM) and Emergency Department Benchmarking Alliance (EDBA) survey results. We defined academic EDs as primary teaching sites for emergency medicine (EM) residencies and non-academic EDs as sites with minimal resident involvement. We constructed the academic and non-academic cohorts from the AAAEM/AACEM and EDBA surveys, respectively, and analyzed metrics common to both surveys. Results Eighty and 454 EDs met inclusion criteria for academic and non-academic EDs, respectively. Academic EDs had more median annual patient encounters (73,001 vs 54,393), lower median proportion of pediatric patients (6.3% vs 14.5%), higher median proportion of EMS patients (27% vs 19%), and were more commonly designated as Level I or II Trauma Centers (94% vs 24%). Median patient arrival-to-provider times did not differ (26 vs 25 min). Median length-of-stay was longer (277 vs 190 min) for academic EDs, and left-before-treatment-complete was higher (5.7% vs 2.9%). MRI utilization was higher for academic EDs (2.2% patients with at least one MRI vs 1.0 MRIs performed per 100 patients). Patients-per-hour of provider coverage was lower for academic EDs with and without consideration for advanced practice providers and residents. Conclusions Demographic and operational performance measures differ between academic and non-academic EDs, suggesting that the two groups may be inappropriate operational performance comparators. Causes for the differences remain unclear but the differences appear not to be attributed solely to the academic mission.http://link.springer.com/article/10.1186/s12873-019-0285-7Emergency departmentOperationsAcademicCommunityBenchmarking |
| spellingShingle | Martin A. Reznek Sean S. Michael Cathi A. Harbertson James J. Scheulen James J. Augustine Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys BMC Emergency Medicine Emergency department Operations Academic Community Benchmarking |
| title | Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys |
| title_full | Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys |
| title_fullStr | Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys |
| title_full_unstemmed | Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys |
| title_short | Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys |
| title_sort | clinical operations of academic versus non academic emergency departments a descriptive comparison of two large emergency department operations surveys |
| topic | Emergency department Operations Academic Community Benchmarking |
| url | http://link.springer.com/article/10.1186/s12873-019-0285-7 |
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