title: Impact of Family Medicine Resident Physicians on Emergency Department Wait Times and Patients Leaving Without Being Seen.
abstract: OBJECTIVE
  To quantify the effect of family medicine resident physicians on emergency department (ED) wait times and patients leaving without being seen or treated.
  
  
  METHODS
  In a medium-volume community ED over twelve months, we used retrospective chart review to compare wait times between patients seen during shifts where staff were working alone versus with a resident. We measured the time from initial triage time to physician initial assessment (T1) and disposition time (LOS), and number of patients leaving without being seen or treated.
  
  
  RESULTS
  In our analysis, 21,141 patients (91% of total visits) were included; 48% were in the staff-with-resident group, and 52% were in the staff-only group. Mean T1 in the resident group was significantly shorter than the staff-only group (1 hour 23 minutes versus 1 hour 38 minutes, difference 15 minutes, 95% CI 13 to 17 minutes, p<0.001). Mean total LOS in the resident group was also reduced (2 hours 38 minutes versus 2 hours 50 minutes, difference 12 minutes, 95% CI 8 to 17 minutes, p<0.001). Fewer patients left without being seen in the resident group than the staff only group (2.8% versus 4.9%, p<0.001). There were no differences in patients leaving without being treated (0.5% versus 0.5%).
  
  
  CONCLUSIONS
  This is the first study to demonstrate that residents are associated with a reduction in ED wait times and patients leaving without being seen in a low-acuity, community hospital, compared to previous studies demonstrating no difference or increased wait times.
authors.affiliation: *Department of Family Medicine,Schulich School of Medicine and Dentistry,The University of Western Ontario,London,ON.
authors.forename: Wang
authors.initials: W
authors.lastname: Xi
authors.affiliation: *Department of Family Medicine,Schulich School of Medicine and Dentistry,The University of Western Ontario,London,ON.
authors.forename: Vikram
authors.initials: V
authors.lastname: Dalal
mesh_terms: D000328:Adult; D004503:Education, Medical, Graduate / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007902:Length of Stay / Q000639:trends*; D008297:Male; D010820:Physicians; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014218:Triage / Q000458:organization & administration*
keywords: Emergency Department; Left Without Being Seen; Length of Stay; Residents; Wait Times