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{
    "pk": 7480,
    "title": "Mid-level Providers Working in a Low-acuity Area are More Productive than in a High-acuity Area",
    "subtitle": null,
    "abstract": "Introduction: Mid-level providers (MLP) are extensively used in staffing emergency departments (ED). We sought to compare the productivity of MLPs staffing a low-acuity and high-acuity area of a community ED.Methods: This is a retrospective review of MLP productivity at a single center 42,000-volume community ED from July 2009 to September 2010. MLPs staffed day shifts (8AM-6PM or 10AM-10PM) in high- and low-acuity sections of the ED. We used two-tailed T-test to compare patients/hour, relative value units (RVUs)/hour, and RVUs/patient between the 2 MLP groups. Results: We included 49 low-acuity and 55 high-acuity shifts in this study. During the study period, MLPs staffing low-acuity shifts treated a mean of 2.7 patients/hour (confidence interval [CI] +/- 0.23), while those staffing high-acuity shifts treated a mean of 1.56 patients/hour (CI +/- 0.14, P < 0.0001). MLPs staffing low-acuity shifts generated a mean of 4.45 RVUs/hour (CI +/- 0.34) compared to 3.19 RVUs/hour (CI +/-0.29) for those staffing high-acuity shifts (P < 0.0001). MLPs staffing low-acuity shifts generated a mean of 1.68 RVUs/patient (CI +/- 0.06) while those staffing high-acuity shifts generated a mean RVUs/patient of 2.05 (CI +/- 0.09, P < 0.0001). Conclusion: MLPs staffing a low-acuity area treated more patients/hour and generated more RVUs/hour than when staffing a high-acuity area. [West J Emerg Med.2013;14(6):598–601.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "emergency medicine productivity"
        },
        {
            "word": "mid-level provider"
        },
        {
            "word": "Medicine"
        }
    ],
    "section": "Provider Workforce",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9dv1d950",
    "frozenauthors": [
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Silberman",
            "name_suffix": "",
            "institution": "St. Luke’s University Hospital and Health Network, Bethlehem, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Donald",
            "middle_name": "",
            "last_name": "Jeanmonod",
            "name_suffix": "",
            "institution": "St. Luke’s University Hospital and Health Network, Bethlehem, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Khalief",
            "middle_name": "",
            "last_name": "Hamden",
            "name_suffix": "",
            "institution": "St. Luke’s University Hospital and Health Network, Bethlehem, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Mark",
            "middle_name": "",
            "last_name": "Reiter",
            "name_suffix": "",
            "institution": "St. Luke’s University Hospital and Health Network, Bethlehem, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Rebecca",
            "middle_name": "K",
            "last_name": "Jeanmonod",
            "name_suffix": "",
            "institution": "St. Luke’s University Hospital and Health Network, Bethlehem, Pennsylvania",
            "department": "None"
        }
    ],
    "date_submitted": "2012-06-21T12:34:28Z",
    "date_accepted": "2012-06-21T12:34:28Z",
    "date_published": "2013-11-05T08:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/7480/galley/4419/download/"
        }
    ]
}