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Expanding ambulatory and urgent care clinics and hospital admission reduction measures have resulted in process modifications within emergency departments. Emergency medicine scheduling is one of the most difficult of all physician scheduling tasks, and it is becoming increasingly difficult.
These department schedules are more complicated than OB-GYN schedules, pulmonology schedules, and anesthesiology schedules because there are more groups to juggle
Five challenges of emergency medicine scheduling are:
1) Duration of stay
Hospitals have long sought ways to improve emergency room traffic flow. One model, in particular, known as split-flow, has gained popularity. Emergency departments consider minutes and hours rather than hospital days. Saving valuable minutes during a patient visit can significantly impact the patient's experience. Split-flow employs a physician at the front door, replacing traditional triage by allowing for early assessment and the provision of initial care. Patients are seen by the intake doctor and then directed to the appropriate level of care. This model has assisted in reducing the amount of time a patient spends in the emergency department. Regardless of how fast the response is, if a hospital's capacity is full, the admitted patient has no choice but to stay in the emergency department (sometimes for hours) until a bed becomes available.
2) Budget-Friendly Scheduling
Hospitals are becoming more conscious of budgetary constraints and the need to do more with less. In other words, they must strike a balance between the patient's needs and the facility's economic drivers. As a result, during a given shift, family practice or internal medicine physicians with emergency medicine experience may outnumber board-certified emergency medicine physicians. Similarly, additional physician assistants may be scheduled before a second or third emergency medicine physician is scheduled. Juggling economic priorities with the needs of individual physicians can be difficult and add to the schedule's complexity.
3) Greater Understanding of Shift Work
While emergency rooms are open 24 hours a day, the human body is not designed to work that way. Indeed, the American College of Emergency Physicians has taken a stand against rotating shifts that disrupt circadian rhythms. ACEP advocates for shifts that are 12 hours or less in length and rotate clockwise. When creating schedules, the organization encourages physician schedulers to consider time off between shifts as well as the total number of hours worked by emergency room physicians. These factors complicate emergency medicine scheduling even more, and adds to the need for shift scheduling efficiencies.
4) Technology
Emergency medical records are still in their early stages of development and have not increased efficiency. In fact, it has lengthened the patient-doctor encounter, which can bog down an emergency department.
5) Employing Locum Tenens Physicians
According to content published by Fierce Healthcare, 85% of healthcare facilities utilized locum tenens. Primary care physicians, hospitalists, behavioral health professionals, specialists, and emergency medicine are all used to fill gaps amid hospital healthcare staffing shortages.
Fortunately, ER physician scheduling can help to improve the efficiency of a hospital’s ER department. It’s especially helpful in medium and large-scale ER departments, but even small hospitals can benefit from its implementation.
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