Effect of a physician assistant on quality and efficiency metrics in an emergency department

Abstract

<h3>Abstract</h3> <h3>Objective</h3> 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. <h3>Design</h3> A retrospective review of ED data from April 1, 2017, to September 30, 2017. <h3>Setting</h3> Belleville General Hospital, a secondary care hospital, ED in Ontario. <h3>Participants</h3> A physician assistant, 13 emergency physicians, and 7 family physicians. <h3>Main outcome measures</h3> 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. <h3>Results</h3> In the PA group, there was a lower average daily left without being seen rate (3.4% vs 5.2%; <i>P</i> &lt; .001), a lower provider initial assessment time at the 90th percentile (3.9 hours vs 4.5 hours; <i>P</i> &lt; .001), a lower average provider initial assessment time (114.83 minutes vs 139.46 minutes; <i>P</i> &lt; .001), and a lower average length of stay (313.85 minutes vs 348.91 minutes; <i>P</i> &lt; .001). <h3>Conclusion</h3> 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.