Effect of a physician assistant on quality and efficiency metrics in an emergency department

Abstract

Objective To determine the effect of a physician assistant (PA) working in a secondary care hospital emergency department (ED) on the overall performance of the ED.

Paired analysis of ED efficiency for low-acuity children treated by PAs and pediatricians

“…To our knowledge, this is the first paired clinician analysis comparing LOS for care rendered by PAs relative to physicians focused specifically on the low-acuity pediatric ED population. Our findings extend previous studies forecasting the role of PAs in pediatric EDs and extend the demonstrated overall positive throughput effects of PAs on ED performance into the pediatric ED realm 4,5,12,16. Given the large proportion of low-acuity patients in pediatric EDs and the expanding use of PAs in the ED, this is relevant from a healthcare administration perspective 17…”

“…Our findings extend previous studies forecasting the role of PAs in pediatric EDs and extend the demonstrated overall positive throughput effects of PAs on ED performance into the pediatric ED realm. 4,5,12,16 Given the large proportion of low-acuity patients in pediatric EDs and the expanding use of PAs in the ED, this is relevant from a healthcare administration perspective. 17…”

“…Studies in general EDs in the United States suggest that PAs have lower productivity, measured in relative value units per hour and patients per hour, than emergency physicians 4,11. Conversely, a recent study in Canada demonstrated a statistically significant difference in ED LOS that favored treatment by a single PA, compared with treatment by family physicians 12. Limited data compare PA with pediatrician efficiency in treating low-acuity children.…”

The contribution of physician associates or assistants to the emergency department: A systematic scoping review

“…14,22,25 De la Roche found a reduction in the initial assessment time for ED PAs compared to emergency doctors (3.9 hours vs 4.5 hours, P < 0.001). 27 Merdler et al 26 reported that if the doctor saw a patient with the assistance of the PA, then they were attended to quicker than if the doctor saw the patient without PA assistance (30.59 minutes vs 47.79 minutes, P < 0.001).…”

“…Waiting times was an outcome measure in 7 studies. 14,[22][23][24][25][26][27] The majority of studies showed PA presence to reduce ED wait times. PAs were reported to be more effective in reducing wait times in lower acuity areas versus high-acuity areas.…”