Emergency Medicine Resident Perceptions of Their Own Throughput Metrics

Cureus. 2026 Aug 13;18(8):e114470. doi: 10.7759/cureus.114470. eCollection 2026 Aug.

ABSTRACT

Background Operational throughput metrics, such as emergency department (ED) length of stay (LOS) and time to disposition, are frequently and routinely tracked in EDs, but they are not usually integrated into resident education as structured formative feedback. The educational impact of routinely sharing individualized metrics with emergency medicine (EM) residents remains unclear. Methods We conducted a prospective pre-post quality improvement (QI) study at a single academic EM residency program between May and September 2025. Post-graduate year two and three residents received weekly individualized throughput metrics, including LOS, greet-to-order time, and disposition time, derived from existing departmental data systems. Metrics were then distributed in a standardized manner for a period of three months. Residents completed structured electronic surveys before and after implementation. Primary outcomes included self-reported perceptions of educational value, workflow impact, emotional response, and behavioral changes. Results A total of 10 residents completed both the pre- and post-intervention surveys. At baseline, familiarity with personal throughput metrics was limited. After three months of metric exposure, 70% rated the metrics as somewhat useful or better. Half of the residents reported making minor changes to their clinical practices. Most residents (60%) reported no stress or anxiety related to receiving these metrics. Reflection on their workflow and recognition of inefficiencies increased, while documentation timeliness and mentor engagement were largely unchanged. However, interest in continued metric use was high (80%). Discussion Weekly individualized throughput metrics were feasible to implement and generally well tolerated by EM residents. Exposure to performance data was associated with increased self-reported reflection and modest behavioral adjustments without a significant emotional burden. Based on this, performance metrics may serve as a useful adjunct to residency education when framed as formative feedback. These findings suggest that integration with structured mentorship may be necessary to achieve sustained behavioral changes. This implementation strategy provides a framework for future studies evaluating structured mentorship or coaching alongside individualized performance metrics. Conclusion EM residents receiving a weekly metric report have modest behavioral adjustments regarding the metrics received. Residents reported minimal emotional burden after this strategic implementation of weekly individualized throughput metrics.

PMID:42732276 | PMC:PMC13570580 | DOI:10.7759/cureus.114470