Literature DB >> 22810850

Patients who present to the emergency department and leave without being seen: prevalence, predictors and outcomes.

Julia Crilly1, Nerolie Bost, Lukman Thalib, Jo Timms, Heidi Gleeson.   

Abstract

OBJECTIVE: To identify the prevalence, predictors and outcomes of patients who leave without being seen (LWBS) in one hospital emergency department (ED).
MATERIALS AND METHODS: A descriptive, retrospective cohort study design was used. Data were extracted from the ED Information System. Multivariate logistic regression identified independent predictors of patients who LWBS. Two main outcomes were studied: the proportion of patients who waited longer than recommended and the proportion of patients who represented to the ED within 72 h.
SETTING: A large regional teaching hospital ED in South East Queensland, Australia. SAMPLE: A total of 64 292 patient presentations made to the ED from 9 August 2008 to 8 August 2009.
RESULTS: The prevalence of patients who LWBS was 10.7%. Independent predictors of LWBS included younger age, lower urgency triage category allocation, arrival by means other than ambulance, evening and night shift presentations, winter season, weekend presentations and presenting complaint category of 'gastrointestinal' or 'paediatric'. When compared with patients who waited, those who LWBS comprised higher proportions of waiting longer than recommended (LWBS: 77.2% vs. waited: 52.0%, P<0.001) and higher proportions of representations to ED within 72 h (LWBS: 10.3% vs. waited: 5.4%, P<0.001).
CONCLUSION: Outcomes investigated in this study indicate that room for improvement exists not only for patients who LWBS but all patients presenting to the ED. The most powerful predictors of LWBS were lower urgency triage allocation and evening and night shift presentations. This suggests that service improvements could be targeted during 'out of business hours' for those with less emergent conditions.

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Year:  2013        PMID: 22810850     DOI: 10.1097/MEJ.0b013e328356fa0e

Source DB:  PubMed          Journal:  Eur J Emerg Med        ISSN: 0969-9546            Impact factor:   2.799


  8 in total

1.  Effects of emergency department expansion on emergency department patient flow.

Authors:  Bryn E Mumma; James Y McCue; Chin-Shang Li; James F Holmes
Journal:  Acad Emerg Med       Date:  2014-05       Impact factor: 3.451

2.  Patients who leave Emergency Department without being seen or during treatment in the Lazio Region (Central Italy): Determinants and short term outcomes.

Authors:  Francesca Mataloni; Paola Colais; Claudia Galassi; Marina Davoli; Danilo Fusco
Journal:  PLoS One       Date:  2018-12-12       Impact factor: 3.240

3.  Uncompleted emergency department care and discharge against medical advice in patients with neurological complaints: a chart review.

Authors:  Carolin Hoyer; Patrick Stein; Angelika Alonso; Michael Platten; Kristina Szabo
Journal:  BMC Emerg Med       Date:  2019-10-11

4.  Assessing healthcare service quality using routinely collected data: Linking information systems in emergency care.

Authors:  Harald Dormann; Patrick Andreas Eder; Henner Gimpel; Oliver Meindl; Asarnusch Rashid; Christian Regal
Journal:  J Med Syst       Date:  2020-05-08       Impact factor: 4.460

5.  Patients leaving without being seen from the emergency department: A prediction model using machine learning on a nationwide database.

Authors:  Mack Sheraton; Christopher Gooch; Rahul Kashyap
Journal:  J Am Coll Emerg Physicians Open       Date:  2020-09-28

6.  Early quick acuity score provides more complete data on emergency department walkouts.

Authors:  Paris B Lovett; J Akiva Kahn; Stuart E Greene; Matthew A Bloch; Daniel R Brandt; Michael R Minckler
Journal:  PLoS One       Date:  2014-01-17       Impact factor: 3.240

7.  Improved quality and efficiency after the introduction of physician-led team triage in an emergency department.

Authors:  Lena Burström; Marie-Louise Engström; Maaret Castrén; Tony Wiklund; Mats Enlund
Journal:  Ups J Med Sci       Date:  2015-11-09       Impact factor: 2.384

8.  Identifying Patient Door-to-Room Goals to Minimize Left-Without-Being-Seen Rates.

Authors:  Shea Pielsticker; Lori Whelan; Annette O Arthur; Stephen Thomas
Journal:  West J Emerg Med       Date:  2015-10-20
  8 in total

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