Emergency department workforce models: what the literature can tell us

The present study looks at what the literature can tell us about examples of innovative ED staffing. Numerous medical databases, journals specific to emergency care, and key government agency sites were searched to obtain Australian and relevant international literature between 1995 and the present. Studies which discussed appropriate staffing arrangements in the EDs were assessed with preference given to those which gathered evidence about the staff mix. There is little literature available which looks at the entire staffing profile of an ED and assesses its effectiveness. The few papers that do exist conclude that senior staffing, matching peak staffing levels with peak patient demand, having appropriately skilled staff mixes and designing the staff profile based upon individual hospital needs produces the most effective outcomes. Although there are some lessons to be learnt from the success of the staffing of various teams, and the introduction of new roles in the EDs, there are still significant gaps within the literature. There is a need for assessment of the effectiveness of various ED-wide staffing profiles (rather than just individual teams within an ED).