Productivity of Advanced Clinical Practitioners in Emergency Medicine: A 1-year dual-centre retrospective analysis

Int Emerg Nurs. 2020 Jul:51:100879. doi: 10.1016/j.ienj.2020.100879. Epub 2020 May 29.


Background: The ACP role is relatively new in Emergency Medicine (EM) nationally (RCEM, 2017). This work sought to establish the productivity of EM ACPs within our service, to enable evidence-based workforce planning and national benchmarking of this aspect of the role.

Methodology: Data from 1st January 2018-31st December 2018 was retrospectively collected from two hospitals in the United Kingdom (UK) via electronic patient records. In addition to the number of patients seen by ACPs (attending), the number of patients who were seen by an ACP as a senior review (SR) was collected. The productivity was mapped to ACP experience, with patient acuity and disposal reported.

Results: In the study period 239,951 patients were seen in the Emergency Departments (EDs) of the two study hospitals. Overall 20,442 (8.5%) patients received care from an ACP. Mean productivity was 1.03 patients per hour (attending) and 1.53 patients per hour (attending and senior review).

Discussion: EM ACPs form part of the RCEM future workforce strategy to overcome some of the contemporary challenges in EM (Hassan, 2018). To our knowledge, this is the first study which has examined and reported the productivity of ACPs in UK EM.

Conclusion: This paper sets a national benchmark for other EDs by reporting ACP productivity and contributes to the evidence by reporting productivity in other clinician groups. The data presented may be helpful in future national workforce planning for UK EDs.

Keywords: Advanced Clinical Practitioner; Advanced practice; Advanced practice nursing; Emergency Medicine; Organisational productivity; Productivity; Workforce.

Publication types

  • Multicenter Study

MeSH terms

  • Benchmarking
  • Clinical Competence*
  • Efficiency*
  • Emergency Service, Hospital / statistics & numerical data*
  • Health Personnel / statistics & numerical data*
  • Humans
  • Retrospective Studies
  • United Kingdom
  • Workload / statistics & numerical data