Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T07:27:45.408Z Has data issue: false hasContentIssue false
  • English
  • Français

Emergency physician workload modeling

Published online by Cambridge University Press:  11 May 2015

Isser Dubinsky
Isser Dubinsky*
Affiliation:
Department of Family and Community Medicine, University of Toronto, Toronto, ON
*
Department of Family and Community Medicine, University of Toronto, c/o Hay Group, 121 King Street West, 7th Floor, Toronto, ON M5H 3X7; [email protected].

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

A variety of models are used by hospitals, provincial governments, and departments of emergency medicine to “predict” the number of physician hours of coverage necessary to staff emergency departments. These models have arisen to meet specific requirements—some for the purpose of determining hourly rates of compensation, others to determine the amount of funding that will be provided to “purchase” physician coverage, and others to determine the number of hours of coverage necessary to maintain patient waits within “acceptable” limits. All such models have their strengths and weaknesses and have been criticized as not reflecting the “real” needs of any given department.

Objective:

In the article that follows, a review of existing models is presented, annotating their strengths and weaknesses to derive the characteristics of an “ideal” workload model.

Conclusion:

None of the models currently used to measure emergency department workload can be relied on to accurately predict the number of staffed hours necessary. Models that may achieve this objective are suggested.

Keywords

emergencymodelingphysicianworkload
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 4 , July 2012 , pp. 215 - 220
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

References

REFERENCES

1.Report of the Provincial (Ontario) Working Group on Alternative Funding Plans for Academic Health Science Centres. Toronto: Ministry of Health and Long Term Care; 2002 February.Google Scholar
2.Kelen, G, McCarthy, M. The science of surge. Acad Emerg Med 2006;13:1089–94, doi:10.1111/j.1553-2712.2006.tb01627.x.CrossRefGoogle ScholarPubMed
3.Asplin, BR, Flottemesch, TJ, Gordon, BD. Developing models for patient flow and daily surge capacity research. Acad Emerg Med 2006;13:1109–13, doi:10.1111/j.1553-2712.2006.tb01632.x.CrossRefGoogle ScholarPubMed
4.Vertesi, L. Dynamic model for physician staffing. Presented to the School of Industrial Engineering; 2008 Oct; Toronto.Google Scholar
5.Ontario Ministry of Health and Long-Term Care. A guide to ED AFA. Toronto: Ministry of Health and Long Term Care; 2000.Google Scholar
6.Murray, M. Canadian Triage and Acuity System—a Canadian perspective on ED triage. Emerg Med 2003;15:6–10, doi:10.1046/j.1442-2026.2003.00400.x.CrossRefGoogle Scholar
7.George, G, Jell, C, Todd, BS. Effect of population ageing on emergency department speed and efficiency: a historical perspective from a district general hospital in the United Kingdom. Emerg Med J 2006;23:379–83, doi:10.1136/emj.2005.029793.CrossRefGoogle Scholar
8.Beveridge, R, Ducharme, J, Janes, L, et al. Reliability of the Canadian Emergency Department Triage and Acuity Scale: interrater agreement. Ann Emerg Med 1999;34:155–9, doi:10.1016/S0196-0644(99)70223-4.CrossRefGoogle ScholarPubMed
9.Gill, JM, Reese, CL, Diamond, JJ. Disagreement among health care professionals about the urgent care needs of emergency department patients. Ann Emerg Med 1996;28:474–9, doi:10.1016/S0196-0644(96)70108-7.CrossRefGoogle ScholarPubMed
10.McDonald, I, Butterworth, T, Yates, DW. Triage: a literature review 1985–1993. Accid Emerg Nurs 1995;3:201–7, doi:10.1016/0965-2302(95)90005-5.CrossRefGoogle ScholarPubMed
11.Spence, JM, Murray, MJ, Morrison, LJ. Does emergency department activity level affect triage categorization and admission to hospital [abstract]? Acad Emerg Med 2004;11:457.CrossRefGoogle Scholar
12.Innes, GD, Stenstrom, R, Grafstein, E, et al. Prospective time study derivation of emergency physician workload projectors. CJEM 2005;7:299–308.CrossRefGoogle Scholar
13.Dreyer, JF, McLeod, SL, Anderson, CK, et al. Physician workload and the Canadian Emergency Department Triage and Acuity Scale: the Predictors of Workload in the Emergency Room (Power) Study. CJEM 2009;11:321–9.CrossRefGoogle Scholar
14.Emergency Medicine Practice Department, American College of Emergency Physicians. Staffing issues in the emergency department. American College of Physicians; 2003 September.Google Scholar
15.Edwardson, S, Giovanetti, P. Nursing workload measurement systems. Annu Rev Nurs Res 1994;12:95–123.CrossRefGoogle ScholarPubMed
16.O’Brien-Pallas, L, Cockerill, R, Leatt, P. Different systems, different costs? An examination of the comparability of workload measurement systems. J Nurs Adm 1992;22:17–22, doi:10.1097/00005110-199202000-00020.Google ScholarPubMed
17.Celenza, A, Rogers, IR. Qualitative evaluation of a formal bedside teaching program in an emergency department. Emerg Med J 2006;23:769–73, doi:10.1136/emj.2006.037796.CrossRefGoogle ScholarPubMed
18.Sakr, M. Emergency nurse practitioners: a three part study in clinical and cost effectiveness. Emerg Med J 2003;20:158–63, doi:10.1136/emj.20.2.158.CrossRefGoogle ScholarPubMed