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Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys.
BMC Emergency Medicine ( IF 2.3 ) Pub Date : 2019-11-21 , DOI: 10.1186/s12873-019-0285-7
Martin A Reznek 1 , Sean S Michael 2 , Cathi A Harbertson 3 , James J Scheulen 3 , James J Augustine 4
Affiliation  

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.

中文翻译:

学术和非学术急诊科的临床运营:两个大型急诊科运营调查的描述性比较。

背景技术尽管有人建议在临床操作基准方面定期对学术和非学术急诊科(ED)进行比较,但建议这两组患者的临床操作特征可能有所不同。和结果。我们试图描述和比较学术性和非学术性ED的临床操作特征。方法我们使用急诊医学学术管理人员学院(AAAEM)/急诊医学学术主席协会(AACEM)和急诊科对学术和非学术成人和普通ED进行了描述性比较研究,这些研究与每年发生40,000次以上的成人和普通ED进行了比较。标杆联盟(EDBA)调查结果。我们将学术ED定义为急诊医学(EM)住院的主要教学地点,将非学术ED定义为居民最少参与的地点。我们分别从AAAEM / AACEM和EDBA调查构建了学术和非学术队列,并分析了这两个调查共有的指标。结果分别有80个和454个ED满足了学术性和非学术性ED的纳入标准。学术急诊科的年度患者中位数较高(73,001 vs 54,393),儿科患者中位数比例较低(6.3%vs 14.5%),EMS患者中位数比例较高(27%vs 19%),并且更常被指定为I级或II外伤中心(94%比24%)。患者到达提供者的时间中位数没有差异(26 vs 25分钟)。学术急诊科的中位住院时间更长(277 vs 190 min),而治疗完成前的离开时间更长(5.7%vs 2.9%)。学术急诊室的MRI使用率更高(2.2%的患者至少进行一次MRI检查,而每100名患者进行1.0例MRI检查)。不论是否考虑高级医疗服务提供者和住院医师,学术急诊室的每小时服务提供者覆盖率均较低。结论学术性和非学术性ED的人口统计学和运营绩效衡量指标有所不同,这表明两组可能是不合适的运营绩效比较者。差异的原因尚不清楚,但差异似乎并非仅归因于学术使命。
更新日期:2020-04-22
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