Peer pressure isn’t always a bad thing. Placing peer pressure on emergency department (ED) physicians can improve discharge rates and reduce average length of stay, according to a study published in The American Journal of Emergency Medicine.
Researchers created peer pressure by announcing the patient discharge rate of each emergency physician through monthly email reminders. The emails include each physician’s eight-hour discharge rates and average length of stay and compare it to the baseline statistic recorded prior to the intervention. Researchers found that the eight-hour discharge rate increased significantly for all patients following the initiation of the monthly emails, improving from 48.2% to 53.5%. The greatest improvement was observed among Triage level III patients. Patients with a final discharge disposition also had a shorter average length of stay, dropping from 158.3 minutes pre-intervention to 140.4 minutes after intervention. I wonder what other physicians and nurse practitioners feel about using peer pressure or competition among colleagues as a way to promote outcome improvements. Is it a safe and positive way to hold physicians accountable? Could it unfairly stigmatize physicians and NPs who may have an unusually high incidence of complex cases in a given month? Could it lead to premature discharges? What do you think?