Fast does not imply flawed: Analyzing emergency physician productivity and medical errors
Abstract 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 si...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12849 |
| _version_ | 1797835961235668992 |
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| author | Nathan R. Hoot Timothy J. Barbosa Hei Kit Chan Jonathan G. Rogg |
| author_facet | Nathan R. Hoot Timothy J. Barbosa Hei Kit Chan Jonathan G. Rogg |
| author_sort | Nathan R. Hoot |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-09T15:01:00Z |
| format | Article |
| id | doaj.art-9fa2719e078649bcb52a913e96a723b9 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-04-09T15:01:00Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-9fa2719e078649bcb52a913e96a723b92023-05-01T17:36:03ZengWileyJournal of the American College of Emergency Physicians Open2688-11522022-12-0136n/an/a10.1002/emp2.12849Fast does not imply flawed: Analyzing emergency physician productivity and medical errorsNathan R. Hoot0Timothy J. Barbosa1Hei Kit Chan2Jonathan G. Rogg3Department of Emergency Medicine McGovern Medical School at UTHealth Houston Houston Texas USADepartment of Emergency Medicine McGovern Medical School at UTHealth Houston Houston Texas USADepartment of Emergency Medicine McGovern Medical School at UTHealth Houston Houston Texas USADepartment of Emergency Medicine McGovern Medical School at UTHealth Houston Houston Texas USAAbstract 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.https://doi.org/10.1002/emp2.12849EfficiencyEmergency MedicineMedical ErrorsPatient SafetyWorkload |
| spellingShingle | Nathan R. Hoot Timothy J. Barbosa Hei Kit Chan Jonathan G. Rogg Fast does not imply flawed: Analyzing emergency physician productivity and medical errors Journal of the American College of Emergency Physicians Open Efficiency Emergency Medicine Medical Errors Patient Safety Workload |
| title | Fast does not imply flawed: Analyzing emergency physician productivity and medical errors |
| title_full | Fast does not imply flawed: Analyzing emergency physician productivity and medical errors |
| title_fullStr | Fast does not imply flawed: Analyzing emergency physician productivity and medical errors |
| title_full_unstemmed | Fast does not imply flawed: Analyzing emergency physician productivity and medical errors |
| title_short | Fast does not imply flawed: Analyzing emergency physician productivity and medical errors |
| title_sort | fast does not imply flawed analyzing emergency physician productivity and medical errors |
| topic | Efficiency Emergency Medicine Medical Errors Patient Safety Workload |
| url | https://doi.org/10.1002/emp2.12849 |
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