title: Attending physician coverage in a teaching hospital's emergency department: effect on malpractice.
abstract: It seems self-evident that the establishment of 24-hour per day attending physician coverage in a teaching hospital's emergency department would enhance risk management. However, prior to this study, little investigation had been done to corroborate the effects of full-time emergency department attending physician coverage. In a retrospective study from a large teaching hospital's emergency department, malpractice claims filed for 1985-1987 (part-time attending physician coverage) were analyzed and compared to those for 1987-1989 (full-time attending physician coverage). A total of 98 claims were filed; these data were derived from 466,862 patient visits. Attending physician presence increased from 6000 hours per year in 1985-1987 to 26,280 hours per year in 1987-1989. There was an 18.5% decrease in claims filed, and a 70.1% decrease in disbursements for the first 2 years after the introduction of full-time attending physician coverage as compared with the preceding 2 years. These findings suggest that full-time attending physician coverage in the emergency department is associated with improved risk management.
authors.affiliation: University of Miami School of Medicine, Department of Pediatrics, FL 33101.
authors.forename: S
authors.initials: S
authors.lastname: Press
authors.forename: S A
authors.initials: SA
authors.lastname: Russell
authors.forename: J C
authors.initials: JC
authors.lastname: Cantor
authors.forename: E
authors.initials: E
authors.lastname: Jerez
mesh_terms: D004636:Emergency Service, Hospital; D005431:Florida; D006784:Hospitals, Teaching; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice / Q000191:economics / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000331:legislation & jurisprudence; D012189:Retrospective Studies; D012308:Risk Management; D000078329:Workforce