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Maximizing Patient Coverage Through Optimal Allocation of Residents and Scribes to Shifts in an Emergency Department

  • Systems-Level Quality Improvement
  • Published:
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Abstract

Residents and scribes in an Emergency Department (ED) work closely with an attending physician. Residents care for patients under the supervision of the attending physician, whereas scribes assist physicians with documentation contemporaneously with the patient encounter. Optimal allocation of these roles to shifts is crucial to improve patient care, physician productivity, and to increase learning opportunities for residents. Since resident and scribe availability varies on a monthly basis, the allocation of these roles into different shifts within a pre-designed ED physician shift template must be dynamically adjusted. Using historical patient flow timestamp data as well as information about the patient-coverage capacity of an ED care team, a data-driven model was developed for optimally determining which shifts must be staffed by residents and scribes to maximize patient coverage and to calculate the relative importance of a shift. This relative importance metric aids decision-making in adjusting the allocation of residents and scribes to various shifts as their availability fluctuates. Since the model uses historical timestamp data, which all EDs are mandated to collect, the approach is generalizable to all EDs.

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Funding

This work is funded in part by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

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Authors and Affiliations

  1. Mayo Clinic Department of Health Sciences Research, Mayo Clinic Kern Center for the Science of Health Care Delivery, 200 First Street SW, Rochester, MN, 55905, USA

    Phichet Wutthisirisart, Kalyan Pasupathy & Mustafa Y. Sir

  2. Siemens Healthineers, Manhasset, NY, USA

    Gabriela Martinez

  3. Mayo Clinic Department of Emergency Medicine, Rochester, MN, USA

    Heather A. Heaton

  4. Aerospace Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, USA

    Moriah S. Thompson

Authors
  1. Phichet Wutthisirisart
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  2. Gabriela Martinez
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  3. Heather A. Heaton
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  4. Kalyan Pasupathy
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  5. Moriah S. Thompson
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  6. Mustafa Y. Sir
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Correspondence to Mustafa Y. Sir.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Wutthisirisart, P., Martinez, G., Heaton, H.A. et al. Maximizing Patient Coverage Through Optimal Allocation of Residents and Scribes to Shifts in an Emergency Department. J Med Syst 42, 212 (2018). https://doi.org/10.1007/s10916-018-1080-9

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  • DOI: https://doi.org/10.1007/s10916-018-1080-9

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