Isn't this a measure of how good your team is rather than an individual?
Shane
Still in deepest Wagga
On 18/5/09 6:37 PM, "Dunn Matthew Dr. (RJC) A & E - SwarkHosp-TR"
<[log in to unmask]> wrote:
>> Sorry, I had my tongue in my cheek Matt.
>>
>
>
> I thought you might. However, it's actually not a bad one. Ray McGlone
> mentioned looking at the number of patients seen by each doctor. The trouble
> with this is that it encourages cherry picking (you can split up patients into
> ambulance patients, resus and minors, but it still encourages cherry picking
> from within each group). More of an issue though is that you'll perform
> "better" on this by seeing patients rather than by keeping an eye on what's
> going on in the department. The advantage of the 4 hour wait instead of this
> is that it shows who is performing best as a team leader. Sometimes that
> involves seeing a lot of the quick patients (either trolley or minors
> yourself); sometimes it involves seeing the most complex patients yourself;
> sometimes it involves taking on all the procedures; sometimes it involves
> sitting in triage; sometimes it involves keeping an eye on the whole
> department, giving a bit of advice on every patient by not being the main
> doctor to see any one of them. The nice thing about it is that it's a measure
> of outcome rather than process (so harder to game on) and that it picks up
> those who are best at performing at consultant level rather than at SHO level.
> Couple it to measures of quality of care possibly including mortality,
> unplanned returns, number of x-rays and investigations done (with high numbers
> being a bad thing), referral rates etc. and you've got a nice measure.
>
> Matt Dunn
>
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