Resident Productivity and Number of Shifts

[DrPepperDO]

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As Chief Resident of a newer program, I am trying to find some data to compare and contrast our program with other programs, so as to help improve and see where we stand.

I would like to ask those of you in other programs a few things.

1) Productivity- how many new pt's are residents seeing per shift by year?

2) Shifts- how many shifts do residents work per block, and how long are they?

I thank everyone who is willing to answer these in advance.

 

[Cerberus]

As Chief Resident of a newer program, I am trying to find some data to compare and contrast our program with other programs, so as to help improve and see where we stand.

I would like to ask those of you in other programs a few things.

1) Productivity- how many new pt's are residents seeing per shift by year?

2) Shifts- how many shifts do residents work per block, and how long are they?

I thank everyone who is willing to answer these in advance.

Does your PD have access to cord? If you this was recently discussed (altgough i dont have numbers available at present).

 

[DrPepperDO]

Does your PD have access to cord? If you this was recently discussed (altgough i dont have numbers available at present).

Quite honestly, I don't know if he would give accurate numbers in an attempt to increase our own... I just want to know myself where we stand so that I can help improve things where we actually need to

As far as productivity, I think most of us are exactly where we need to be, maybe even better (though some attendings who went to malignant programs think differently)

As far as shifts, we do work fewer than many, but some attendings (again, those who trained in malignant programs) feel we don't work enough shifts

 

[pratik7]

I think that pts per hour are about 1, 1.5, just under 2 for years 1-3. Much of that depends on the set up, acuity, autonomy of the residents and speed of the attending you are working with. I think average number of shifts is about 16-18 ten hour shifts or 15ish 12s plus the required conference time, reading research and other nonsense.

 

[WilcoWorld]

I do not have data for you, just my opinion.

Having worked at 3 different programs I think a fair rough estimate is for residents to be seeing 1 pt/hr by the end of 1st year, 1.5/hr by the end of second year and 2+/hr by the end of 3rd year. However, things vary widely based on several factors:

1- Acuity: If you're working in fast track you should be beating the above numbers, if you're working a critical care pod you'll probably be below those numbers.
2- ED throughput: If your ED is efficient and average LOS is under 4 hours then your residents should be able to hit the above numbers without too much trouble. If you work in an ED where 1/4 of the labs "hemolyze" and need to be redrawn, 1/3 of the CT's get cancelled by radiology without notifying the ED and need to be re-ordered after an argument with rads and 1/2 of the admission calls result in 2 more calls to other services to fight out who is going to take the patient and the LOS averages 8 hours- then your numbers will be lower.
3- The numbers stated above should apply to how many patients are dispositioned. If resident A sees 30 pts/shift but signs out 15 without a dispo than he is seeing 15/shift. If resident B sees 20 pts/shift and rarely signs out un-dispo'd patients than he is seeing 20/shift and is MUCH more helpful to ED flow than resident A.

Lastly, if the attendings are grumbling about resident efficiency than I hope those same attendings are picking up patients on their own and aren't checking facebook while on shift. On the other hand, if the attending is picking up patients, than the residents better not be on facebook either.

 

[monkeybutt]

At my program we have minimums required:

11 pts/shift in R1
12 pts/shift in R2
13 pts/shift in R3

These are very achievable minimums. Our residents average between 15-25, while our high performers are averaging around 15-20 on a high acuity shift and 25-30 on a low-acuity shift.

We do between 17-20 9-hour shifts per 4-week block.

Feel free to PM me if you want any more information.

 

[deleted109597]

At my program we have minimums required:

11 pts/shift in R1
12 pts/shift in R2
13 pts/shift in R3

These are very achievable minimums. Our residents average between 15-25, while our high performers are averaging around 15-20 on a high acuity shift and 25-30 on a low-acuity shift.

We do between 17-20 9-hour shifts per 4-week block.

Feel free to PM me if you want any more information.

This, while logical, is setting up for a bad process. What if the resident doesn't see 13 in a shift? What if only 7 people walk in the door during the whole shift? Or the department is loaded up and has no outflow?

On the converse, if your program has a minimum, does it have a maximum (either active patients at a time or total in a shift). Because the concept of a minimum number just seems like an odd stick.

Yes, people should be able to see that many, and if they can't routinely, then there's a problem. And at least it's a reasonable number.

 

[monkeybutt]

This, while logical, is setting up for a bad process. What if the resident doesn't see 13 in a shift? What if only 7 people walk in the door during the whole shift? Or the department is loaded up and has no outflow?

On the converse, if your program has a minimum, does it have a maximum (either active patients at a time or total in a shift). Because the concept of a minimum number just seems like an odd stick.

Yes, people should be able to see that many, and if they can't routinely, then there's a problem. And at least it's a reasonable number.

I should clarify that these are averages for the year. If you see fewer than the minimum in one particular shift, NBD.

Also, we work in very busy EDs. There will always be many, many patients to see.

 

[KeepJumping]

We work 19 12 hour shifts (about 6 of these may be 10 hour shifts). Goal is to see at least 1 an hour at R2 and work up to 2-3 an hour. We rarely get even 5 - 10 minutes to eat. Very busy urban center in a large city.

 

[lawj]

At my program we have minimums required:

11 pts/shift in R1
12 pts/shift in R2
13 pts/shift in R3

These are very achievable minimums. Our residents average between 15-25, while our high performers are averaging around 15-20 on a high acuity shift and 25-30 on a low-acuity shift.

We do between 17-20 9-hour shifts per 4-week block.

Feel free to PM me if you want any more information.

Our program numbers are similar to Monkeybutt's. Encouraged to have patients dispoed before signing out. Emphasis on efficiency and department flow is begun during intern year. However, staff will pick up their own patients as well to help with flow.

Shifts are same as well: 17-21 9hr shifts over 4 weeks. Split between low acuity and high acuity.