Objective: There is limited literature examining the impact of changeover on workforce productivity and the number of patients seen per hour by doctors in UK emergency departments. Given the emphasis on key performance indicators, e.g., 4-hour and 12-hour breach targets, trusts may benefit from minimising the impact of predictable decreases in performance metrics, such as those occurring when new doctors rotate.
Material and Methods: The mean number of patients seen per hour was calculated for 49 doctors in training in a UK emergency department over a 4–6-month period. Trends were analysed to predict the impact of changeover on productivity for each group of trainees.
Results: When averaged across all trainees, there was an increase of 0.011 patients seen per hour per week. Over the course of an 18-week rotation, this would equate to approximately 1.6 additional patients seen per doctor per shift. When analysed individually, there was a statistically significant increase in the number of patients seen per hour among FY2, GP, and ACCS trainees, although only GP trainees remained statistically significant after correction for multiple comparisons.
Conclusion: Doctors in a UK emergency department appear to increase the number of patients seen per hour during their rotation. This suggests that decreases in departmental performance at changeover may follow a predictable pattern, although conclusions should be drawn with caution due to multiple limitations, including the single-centre nature of the study.
Keywords: Emergency Department Performance Metrics, Impact of Doctors’ Rotations, Workforce Productivity
, Oliver Meek2 
