Attending physician productivity peaks at the beginning of the shift, starting with about 3 new patients in the first hour and decreases as the shift progresses.  This has important implications for staffing models.  Assuming a simple, uniform average over the shift won't work.

Emergency severity index (ESI) scores were highly variable and inaccurate in this multicenter, international study.  The most important thing to take away is to not be falsely reassured by low-acuity ESI scores.  View them with healthy skepticism.

Lack of a MICU bed doesn't mean the ED patient is not critically ill.  The longer patients whom the ED determined needed ICU care boarded in the ED before being moved to the ICU, the greater the odds of mortality.

Our patients face serious obstacles when trying to get timely follow up from the ED. This secret shopper study found that only 32% could obtain 7-day follow up.  The best predictor of getting 7-day follow up was when the caller posed as having commercial insurance.

Influenza particles are released simply by breathing.  That means, a person does not have to cough or sneeze to spread the flu - just breathing will do it.  This has infection control implications.

Failure of private hospitals to care for the uninsured resulted in informal ED to ED referrals, which meant up to 20% increased volume in public EDs for certain diagnoses, particularly orthopedic issues.  This led to duplicate testing, increased cost, complications, delays in care, and poor treatment of the most vulnerable patients.

Inadvertent poisoning with an opiate in the prehospital setting is unlikely, especially with routine personal protective equipment (gloves).

There is no such thing as a "black cloud."  Those who self-identified as a black-cloud were also identified as such by their peers, but a look at the actual PED metrics showed no statistical difference except higher admission rate.  I'm not sure I believe this, but there you go...

Push alerts for troponin results to a physician's smartphone decreased time to disposition by 26 minutes, but it didn't affect total length of stay.

Patient satisfaction is important.  But the most commonly used metric in the US, the Press Ganey survey, may not be a good measure of individual emergency physician and clinician performance.  Giving emergency clinicians feedback on their Press Ganey scores, ostensibly so they could take steps to improve, did not lead to appreciable score improvements.