The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Invited Commentary

Commentary on "Impact of Trainees on Length of Stay in the Emergency Department at an Academic Medical Center"

Authors: Steve Baldwin, MD

Abstract

Like many other components of the US healthcare system, emergency departments (EDs) are struggling to deal with the major clinical and nonclinical challenges of our current healthcare environment. Strong and growing clinical demands of patients and referring sources often are matching or exceeding ED capabilities and capacities. Additional imperatives are requiring improvements in quality, safety, and patient and caregiver satisfaction. Coexisting nonclinical imperatives include numerous regulatory and payer requirements for increased data collection, reporting, computerization, compliance auditing, internal controls, and other overhead. Financial imperatives to constrain utilization, costs, and prices are omnipresent. The main strategy available to achieve all of these imperatives from the ED perspective is to increase productivity through process and value improvement because EDs generally cannot greatly influence or control the flux of patients seeking their services.

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