Many emergency physicians have documented the loss of productivity and difficulties in patient flow when information systems do not support the role of physicians and APPs.
At the initiation of the EDBA studies 21 years ago, it was necessary to develop a formula that allowed comparison of staffing ratios where APPs were working in collaboration with emergency physicians (most patients seen with a physician rather than without). At that time, the shared role of ED patient management by physicians and APPs did not allow the same level of productivity of APPs as physicians. So in calculating the overall productivity of the licensed independent practitioners (physicians plus APPs) in an ED, the APP hours were assigned a factor of 0.5 the number of physician hours.
Example: An ED sees an average of 100 patients a day and uses 40 scheduled physician hours and 20 scheduled APP hours.