Search
A recently published commentary highlights the importance of looking beyond the numbers and remembering the core mission of emergency practice. It warns against “gaming” the system to create processes that give better metrics using the example of rates of patients who leave without being seen (LWBS). In the author’s words, efforts aimed at improving this metric create strategies that “raise concerns about distributive justice, beneficence, and professional integrity.” See link for key take home points.
Additional Information
Key points from this commentary:
- Administrators are tied to metrics to demonstrate ED performance and support hospital revenue
- The focus on improving LWBS has led to initiatives like provider in triage, sub-waiting rooms, and expedited workups, which may compromise the care that we provide with disjointed care teams, cursory evaluations, and a focus on seeing more patients, rather than those in most immediate need first.
- As the author highlights, “metrics are not neutral… they reshape behavior in ways that can conflict with the fundamental aims of medical practice.”
References
N.Chhabra, “When Metrics Replace Values: Ethical Concerns in Healthcare Performance Measures,” Academic Emergency Medicine. 33, no. 5 (2026): e70330, https://doi.org/10.1111/acem.70330.