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Improving Patient Flow, Patient Safety and Physician Wellbeing in the Emergency Department

Dr. Kevin Taaffe
Harriet and Jerry Dempsey Professor of Industrial Engineering
Interim Department Chair
Clemson University
Friday, March 19, 2021  3:30-4:20pm


Emergency Department (ED) physicians deal with complicated care settings with frequent exposure to stressful conditions. This manifests itself by impacting physician wellbeing and patient safety.

Physician wellbeing can be measured in many ways, and one such measure is physician burnout. Burnout in physicians is increasing every year, and one of the most prone groups is emergency medicine. This research sought to understand if there was a difference in the stress levels and burnout rate among attending and resident physicians working in the emergency department on the same shift. Twelve attending and resident physicians from Greenville Memorial Hospital in Greenville, SC, participated in the study. Stress levels were estimated using physiological measures, including heart rate variability and electrodermal activity. Attending physicians showed a higher heart rate variability for the entire shift and during the trauma events, implying a lower level of stress. Furthermore, attending physicians recorded a lower workload index. However, no significant differences were observed in the burnout scores.

While physician burnout can certainly impact patient safety, there are other factors at play. The ED is an environment prone to high error rates with severe consequences. Prior studies report that miscommunication contributes to 80% of the serious medical errors. Handoffs, or transfer of patient care from one physician to another, are a common occurrence and are predisposed to errors as a result of interruptions and high workload. Moreover, the Institute of Medicine reported that a majority of treatment delays are a result of communication errors associated with shift change. A simulation model was developed to test various physician to patient assignment policies to minimize the number of handoffs and reduce the workload at the end of a shift. Policies are suggested that restrict physicians from receiving high acuity patients late in their shift, as well as limits to the maximum number of patients per physician. Moreover, a new physician shift scheduling model is proposed that simultaneously reduces physician handoffs, number of physicians required for coverage, and patient waiting time in the ED.


Kevin M. Taaffe, Ph.D., the Harriet and Jerry Dempsey Professor and Chair in Industrial Engineering at Clemson University, has 30 years of industry and academic experience. After receiving B.S. and M.S. degrees in Industrial Engineering from the University of Illinois, Dr. Taaffe worked in the transportation logistics industry (American Airlines, Sabre) for eight years, before returning to academia to obtain his Ph.D. from the University of Florida. Dr. Taaffe’s research interests include the application of simulation and optimization in healthcare, production, and transportation logistics. In particular, Dr. Taaffe focuses on healthcare logistics problems that range from patient flow to operating room management to clinical space capacity management. Dr. Taaffe has worked with clinicians, administrators, managers, and support staff to identify and solve problems related to the patient and staff experience on the day of surgery. Dr. Taaffe began his career working as a transportation planning consultant, and there is a logical research thrust that has resulted from this experience. He has always enjoyed working on industry-sponsored projects that bridge the gap between theoretical research and application. This academic/industry collaboration is a theme of Dr. Taaffe’s interest, as can be seen by his named professorship. Harriet and Jerry Dempsey provided this professorship in an effort to strengthen the research ties between Clemson University and Prisma Health – Upstate.  In addition to his academic and research interests, Dr. Taaffe plays an important role in the Institute of Industrial and Systems Engineers (IISE) where he serves as the Senior VP of North American Operations. In this role, he is helping students and professionals get the most out of their professional organization.