• Benchmarking expectations for interventions to reduce emergency department use among today's high users

      Davis-Martin, Rachel E.; Boudreaux, Edwin D; Flahive, Julie M.; Bergman, Aaron L.; Ash, Arlene S. (2022-01-22)
      This study quantifies changes in numbers of ED visits for high users when there was no specific intervention targeting ED use.
    • Clinical operations of academic versus non-academic emergency departments: a descriptive comparison of two large emergency department operations surveys

      Reznek, Martin A.; Michael, Sean S.; Harbertson, Cathi A.; Scheulen, James J.; Augustine, James J. (2019-11-21)
      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.
    • Scholarly Productivity and Impact: Developing a Quantifiable, Norm-based Benchmarking Methodology for Academic Emergency Medicine

      Boudreaux, Edwin D; Higgins, Stephen E. Jr; Reznik-Zellen, Rebecca C.; Wang, Bo; Volturo, Gregory A. (2019-06-01)
      BACKGROUND: Quantifying and benchmarking scholarly productivity of emergency medicine faculty is challenging. While performance indicators including publication and citation counts are available, use of indicators to create normative references has lagged. The authors developed methodology to benchmark emergency medicine academician scholarly productivity (e.g., publications over time) and impact (e.g., citations per publication over time) against an appropriate reference group. METHODS: The methodology includes: 1) define time frame and scholarly metrics; 2) identify representative population; 3) reconcile alternative author names; 4) use analytic tool to identify scholarly output; 5) build database containing metrics; and 6) create benchmarking statistics, including subsamples. This study included emergency medicine faculty from 2011 to 2015, with total peer-reviewed publications and citations per publication as scholarly metrics. RESULTS: In the United States at the time of the search (2016) there were 200 academic emergency departments, 186 with public faculty listings, which yielded 6,727 academicians. For each academician, the authors calculated statistics about peer-reviewed publications and average citations per publication from 2011 to 2015 and created benchmarking rulers using percentile ranks. Productivity by year of graduation with terminal degree was compared within each subsample, finding that newly graduated faculty demonstrated higher productivity than their within-rank peers who graduated earlier. Finally, benchmarking tables were created that allow comparison of peer-reviewed publication counts and citations per publication for individual academicians against the norm. CONCLUSIONS: This benchmarking method can serve as a model for norm-based scaling of scholarly productivity for emergency medicine. This has important implications for performance review, promotion and hiring, and evaluating group productivity.