Physician score cards cut resource use in pediatric ER
(HealthDay)—An intervention that provides comprehensive physician feedback on practice patterns relative to peers can reduce resource use in the pediatric emergency department, without compromising efficiency or quality of care, according to a study published online Aug. 10 in Pediatrics.
Shabnam Jain, M.D., M.P.H., from the Emory University School of Medicine in Atlanta, and colleagues developed a tool for comprehensive physician feedback on practice patterns relative to peers and examined its impact. Resource use, emergency department length of stay, and 72-hour return to emergency department were reported on scorecards, showing physician practice relative to peers. The authors included 51,450 patient visits (24,834 preintervention and 26,616 postintervention), attended by 96 physicians.
The researchers found that after the intervention there was a reduction in abdominal and pelvic and head computed tomography scans, chest radiographs, intravenous antibiotics, and ondansetron (all P < 0.01). There were also decreases in hospital admissions (from 7.4 to 6.7 percent; P = 0.002), length of stay (from 112 to 108 minutes; P < 0.001), and return rate (2.2 to 2.0 percent). Significant reductions were seen in laboratory test use (P < 0.001) and in intravenous antibiotics (P < 0.05). There was an increase in admission trends but no change in trends for use of computed tomography scans and plain abdominal radiographs.
"Physician feedback on practice patterns relative to peers results in reduction in resource use for several common emergency department conditions without adversely affecting emergency department efficiency or quality of care," the authors write.
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