ED Efficiency: Working Smarter, Not Harder

ED Efficiency: Working Smarter, Not Harder

April 15, 2022



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Kim Bambach, MD

Medical Education Fellow
Interim Assistant Director of the Kiehl Wellness Endowment
The Ohio State University Wexner Medical Center
Twitter: @kimbambach
EMRA*Cast Episodes


Eric Blazar, MD

Clinical Assistant Professor of Emergency Medicine
Rowan University
Inspira Medical Center

Guy Carmelli, MD

Assistant Professor, University of Massachusetts Medical School
Department of EMergency Medicine
UMass Memorial Medical Center

Have you ever felt like you're spinning your wheels in your emergency department? EMRA*Cast host Kim Bambach, MD, (@KimBambach) explores how to work smarter, not harder. Guests Eric Blazar, MD (@eblazar) and Guy Carmelli, MD (@GuyCarmelli) focus on how to improve efficiency so you can spend more time on the things that made you want to go into medicine in the first place.


Do you want to optimize your ED workflow to work smarter, not harder? In this episode, Dr. Guy Carmelli and Dr. Eric Blazar discuss their ED efficiency curriculum, including tips you can use on your next shift. Efficiency is not just about your ED stats; it can improve patient care as well as your personal wellness by allowing you to spend more time on what matters. 

Key Points

  • It helps to think of efficiency in terms of the entire emergency department, not just your personal workflow. Your workflow affects others and vice versa, so consider how you can move the department as a whole. 
  • It's never too early to work on efficiency and build good habits. 
  • A cornerstone of efficiency is effective communication - with patients and with your colleagues.
  • Being a patient in the ED can be a disorienting experience. Setting expectations for the flow of their ED stay, the timing of results, and likely disposition can help your patients navigate their care and minimize interruptions in your workflow. 
  • Prioritizing dispositions early is paramount to efficient practice. Establishing your patient’s disposition early sets key steps in motion for patient care. 
  • Anticipate roadblocks early: what is the rate-limiting step? By anticipating roadblocks you can address them effectively and limit delays in patient care or interruptions that tax your cognitive load on busy shifts. 
  • When possible, place orders and perform tasks in parallel, not in series to optimize your workflow and prevent delays. 
  • Most of what we do as emergency physicians is rapid task-switching, not multitasking. Anticipating roadblocks can help you alternate between tasks in a chaotic environment without becoming derailed. 
  • Efficiency is a learned skill: be kind to yourself and gradually incorporate these efficiency strategies into your practice. 
  • Efficiency may sometimes be at odds with your other goals or your patient's needs, so be cognizant of when efficiency should take a back seat on shift. 

Key Resources

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