Emergency Department Efficiency in an Academic Hospital: A Simulation Study

Abstract

This study examined the effects of the resident education model on the efficiency of a teaching hospital emergency department. Patient data was collected from the University of Maryland Medical Center in Baltimore, MD. This data consisted of both patient information physically collected in the emergency department, as well as historical patient information accessed through the hospital’s electronic databases. Simulation modeling was then used to analyze in a statistically significant manner the effects of the resident education model on patient throughput in the emergency department. We determined that the presence of residents in the ED improves patient throughput for both high-priority and low-priority patients. However, this improvement is higher for lowpriority patients than for high-priority patients, which is a novel result. Future studies will entail determining how replacing residents with other types of personnel, such as nurse practitioners or other types of physicians, affects patient throughput.