Premium
Characteristics favouring a delayed disposition decision in the emergency department
Author(s) -
PerimalLewis L.,
Hakendorf P. H.,
Thompson C. H.
Publication year - 2015
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12618
Subject(s) - medicine , emergency department , overcrowding , referral , retrospective cohort study , duration (music) , emergency medicine , pediatrics , family medicine , nursing , art , literature , economics , economic growth
Background The working hours of a hospital affects efficiency of care within the emergency department ( ED ). Understanding the influences on ED time intervals is crucial for process redesign to improve ED patient flow. Aim To assess characteristics that affect patients' transit through an ED . Methods Retrospective cohort study from 2004 to 2010 of 268 296 adult patients who presented to the ED of an urban tertiary‐referral A ustralian teaching hospital. Results After adjustment for A ustralasian T riage S cale ( ATS ) category, every decade increase in age meant patients spent an additional 2 min in the ED waiting to be seen ( P < 0.001) and an extra 29‐min receiving treatment ( P < 0.001). For every additional 10 patients in the ED , the ‘waiting time’ ( WT ) phase duration increased by 20 min ( P < 0.001) and the ‘ A ssessment and T reatment T ime’ ( ATT ) phase duration increased by 26 min ( P < 0.001). When patients arrived outside working hours, the WT phase duration increased by 20 min ( P < 0.001). When seen outside working hours, the ATT phase duration increased by 34.5 min ( P < 0.001). Conclusion Extrinsic to the patients themselves and in addition to ED overcrowding, the working hours of the hospital affected efficiency of care within the ED . Not only should the whole of the hospital be involved in improving efficient and safe transit of patients through an ED , but the whole of the day and every day of the week deserve attention.