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Effectiveness of Resident Physicians as Triage Liaison Providers in an Academic Emergency Department

Emergency department (ED) crowding is associated with detrimental effects on ED quality of care. Triage liaison providers (TLP) have been used to mitigate the effects of crowding. Prior studies have evaluated attending physicians and advanced practice providers as TLPs, with limited data evaluating...

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Bibliographic Details
Published in:The western journal of emergency medicine 2017-06, Vol.18 (4), p.577-584
Main Authors: Weston, Victoria, Jain, Sushil K, Gottlieb, Michael, Aldeen, Amer, Gravenor, Stephanie, Schmidt, Michael J, Malik, Sanjeev
Format: Article
Language:English
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Summary:Emergency department (ED) crowding is associated with detrimental effects on ED quality of care. Triage liaison providers (TLP) have been used to mitigate the effects of crowding. Prior studies have evaluated attending physicians and advanced practice providers as TLPs, with limited data evaluating resident physicians as TLPs. This study compares operational performance outcomes between resident and attending physicians as TLPs. This retrospective cohort study compared aggregate operational performance at an urban, academic ED during pre- and post-TLP periods. The primary outcome was defined as cost-effectiveness based upon return on investment (ROI). Secondary outcomes were defined as differences in median ED length of stay (LOS), median door-to-provider (DTP) time, proportion of left without being seen (LWBS), and proportion of "very good" overall patient satisfaction scores. Annual profit generated for physician-based collections through LWBS capture (after deducting respective salary costs) equated to a gain (ROI: 54%) for resident TLPs and a loss (ROI: -31%) for attending TLPs. Accounting for hospital-based collections made both profitable, with gains for resident TLPs (ROI: 317%) and for attending TLPs (ROI: 86%). Median DTP time for resident TLPs was significantly lower (p
ISSN:1936-900X
1936-9018
1936-9018
DOI:10.5811/westjem.2017.1.33243