Adding More Junior Residents May Worsen Emergency Department Crowding

摘要: Background Although increasing staff numbers during shifts when emergency department (ED) crowding is severe can help meet patient demand, it remains unclear how different types of added staff, particularly junior residents, may affect crowding. Methods To identify associations between and ED crowding, we conducted a cross-sectional, single-center study in the large, teaching hospital Japan January December 2012. Patients who visited period were enrolled. We excluded (1) patients previously scheduled to visit ED, (2) neonates transferred from other hospitals. During period, 27,970 Types analyzed (first second year) senior (third fifth attending (board-certified) physicians, nurses. A generalized linear model was applied length stay for all as well admitted discharged quantify an association with additional staff. Results In model, addition one physician or resident associated decreased total by 3.88 1.64 minutes, respectively (95% CI, 2.20–5.56 0.81–2.48 minutes); while nursing had no association. Surprisingly, however, prolonged 0.97 minutes CI 0.37–1.57 minutes) 1.01 0.45–1.59 minutes). Conclusion Staffing adjustments aimed at alleviating should focus on adding more peak-volume shifts.