Impact of Family Medicine Resident Physicians on Emergency Department Wait Times and Patients Leaving Without Being Seen

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 T-1 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.