Educating Emergency Medicine Residents in Emergency Department Administration and Operations: Needs and Current Practice

Abstract

BACKGROUND: Emergency medicine (EM) residents are expected to develop competence in emergency department (ED) administration and operations. OBJECTIVES: We assessed current needs and educational practices related to preparing EM residents for their role in ED operations, and explored whether there was an association between program characteristics and the presence of ED operations education in US EM residency programs. METHODS: We conducted a cross-sectional needs assessment, using a web-based survey sent to all US EM residency programs to assess program characteristics, provision of ED operations-related lectures, availability of an ED administrative fellowship, and presence of a formal ED operations curriculum. Logistic regression was used to determine if any program characteristics were associated with the presence of lectures and a formal operations curriculum. RESULTS: Of the 158 Accreditation Council for Graduate Medical Education-accredited EM programs, 117 (74%) responded. Of these, 109 (93%) respondents had at least 1 lecture on ED operational topics. Sixty programs (54%) measured resident productivity. Knowledge of Centers for Medicaid & Medicare Services reimbursement guidelines was significantly positively associated with presence of an ED operations curriculum (OR, 3.52, P = .009) and with lectures on patient satisfaction (OR, 3.99, P = .006). Measuring resident productivity was positively associated with having lectures on productivity (OR, 2.50, P = .02) and with ED throughput (OR, 2.32, P = .03). No 2 variables were simultaneously significant in the model. CONCLUSIONS: Most EM programs had at least 1 lecture on ED operations topics. Roughly half of the programs measured resident productivity and half had a formal ED operations curriculum.