Breyer Michael, Farley Heather, Neyman Greg, Nichols Wendy, Kendall John
Denver Health Medical Center, University of Colorado School of Medicine, Denver, Colorado.
Christiana Care Health System, Newark, Delaware.
J Emerg Med. 2017 Nov;53(5):765-770. doi: 10.1016/j.jemermed.2017.08.010.
Emergency physicians (EPs) are expected to deliver quality care while maintaining high levels of efficiency and productivity as measured by the relative value unit (RVU).
We sought to determine whether academic EPs with higher RVUs spend less time at the bedside than their colleagues.
This was a prospective, observational, cohort study. A 13-item task list was generated, pilot-tested, and placed onto a computerized tablet.
There was no difference among EPs in terms of time spent at bedside, 26.7% of total time, 17.31 min (95% confidence interval [CI] 14.43-20.19), p = 0.052; resident interaction 13.1%, 8.46 min (95% CI 4.68-12.25), p = 0.959; charting, 11.1%, 7.17 min (95% CI .746-5.65), p = 0.055; information search, 10.5%, 6.80 min (95% CI 0.84-8.52), p = 0.320; walking, 9.0%, 5.86 min (95% CI 5.17-6.54), p = 0.112; consultant interaction, 8.2%, 5.28 min (95% CI 3.18-7.40), p = 0.404; writing orders, 6.5%, 4.19 min (95% CI 3.22-5.15), p = 0.109; nursing interaction, 5.6%, 3.65 min (95% CI 2.54-4.76), p = 0.260; other, 5.2%, 3.65 min (95% CI 1.76-5.02), p = 0.785; medical student interaction, 4.2%, 2.75 min (95% CI 0.53-4.97), p = 0.102; physician assistant interaction, 2.8%, 1.79 min (95% CI 1.08-2.50), p = 0.959; clerical interaction, 1.7%, 1.13 min (95% CI .69-1.57), p = 0.335; and electrocardiogram interpretation, 0.7%, 0.45 min (95% CI .32-.58), p = 0.793.
Despite differences in RVU-based productivity data, academic EPs spend similar amounts of time involved in the daily tasks of taking care of patients, underscoring that direct physician-patient interaction is one practice parameter that is not compromised among these EPs.
急诊医生（EPs）需要在保持高效率和高生产力（以相对价值单位（RVU）衡量）的同时提供高质量的医疗服务。
我们试图确定RVU较高的学术型急诊医生在床边花费的时间是否比他们的同事少。
这是一项前瞻性观察队列研究。生成了一份包含13个项目的任务清单，进行了预测试，并放置在电脑平板电脑上。
急诊医生在床边花费的时间（占总时间的26.7%，即17.31分钟（95%置信区间[CI]为14.43 - 20.19），p = 0.052）、与住院医师互动（13.1%，即8.46分钟（95% CI为4.68 - 12.25），p = 0.959）、书写病历（11.1%，即7.17分钟（95% CI为0.746 - 5.65），p = 0.055）、信息搜索（10.5%，即6.80分钟（95% CI为0.84 - 8.52），p = 0.320）、行走（9.0%，即5.86分钟（95% CI为5.17 - 6.54），p = 0.112）、与会诊医生互动（8.2%，即5.28分钟（95% CI为3.18 - 7.
