Increasing off-service resident productivity while on their emergency department rotation using shift cards

Bharath Chakravarthy, Emerson Posadas, Deena Ibrahim, Kurt Mcarthur, Megan Osborn, Wirachin Hoonpongsimanont, Andrew Wong, Shahram Lotfipour

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: Differences in productivity between off-service residents rotating in the emergency department (ED) and their emergency medicine (EM) resident counterparts have never been directly quantified. Objectives: We sought to quantify the difference between off-service residents rotating in the ED and their EM resident counterparts.We also sought to find whether shift cards could be used to increase the productivity of off-service residents rotating in the ED. Methods: This is a prospective cohort study conducted at an urban, tertiary, Level I trauma center.We implemented the use of shift cards for off-service residents during their EM rotation. Completion of the shift card involved recording patients seen and their dispositions, procedures done, and documenting a learned bedside teaching point from their shift that day. Productivity was measured in terms of patients seen per hour (PPH) and relative value units per hour (RVU/h). Results: Off-service residents showed a productivity of 0.529 PPH (95% confidence interval [CI] 0.493-0.566) and 1.40 RVU/h (95% CI 1.28-1.53) prior to implementation of shift cards. With the introduction of shift cards, productivity increased to 0.623 PPH (95% CI 0.584-0.663, p = 0.001) and 1.77 RVU/ h (95% CI 1.64-1.91, p = 0.001). In comparison, first year EM resident productivity was 0.970 PPH (95% CI 0.918- 1.02) and 3.01 RVU/h (95% CI 2.83-3.19). Conclusions: Shift cards can be used to foster motivation for off-service residents rotating in the ED, and is a simple and costeffective method to improve system-based practices and utilization of resources.

Original languageEnglish (US)
Pages (from-to)499-505
Number of pages7
JournalJournal of Emergency Medicine
Volume48
Issue number4
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Keywords

  • Education
  • Emergency medicine
  • Off-service
  • Productivity
  • Resident

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Chakravarthy, B., Posadas, E., Ibrahim, D., Mcarthur, K., Osborn, M., Hoonpongsimanont, W., Wong, A., & Lotfipour, S. (2015). Increasing off-service resident productivity while on their emergency department rotation using shift cards. Journal of Emergency Medicine, 48(4), 499-505. https://doi.org/10.1016/j.jemermed.2014.11.001