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. Design A retrospective review of ED data from April 1, 2017, to September 30, 2017. Setting Belleville General Hospital, a secondary care hospital, ED in Ontario. Participants A physician assistant, 13 emergency physicians, and 7 family physicians. Main outcome measures Overall ED performance was evaluated using metrics from the Ontario Ministry of Health and Long-Term Care: rate of patients who left without being seen, provider initial assessment time at the 90th percentile, and the average provider initial assessment time for all patients over a 6-month period. Results In the PA group, there was a lower average daily left without being seen rate (3.4% vs 5.2%; P < .001), a lower provider initial assessment time at the 90th percentile (3.9 hours vs 4.5 hours; P < .001), a lower average provider initial assessment time (114.83 minutes vs 139.46 minutes; P < .001), and a lower average length of stay (313.85 minutes vs 348.91 minutes; P < .001). Conclusion This study suggests that a PA has a statistically significant positive effect on the overall performance of an ED. Future studies should examine the effect of a PA on quality of care and hospital funding.