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Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India.

Tiwari Y, Goel S, Singh A - J Emerg Trauma Shock (2014)

Bottom Line: The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients.Around 71% patients were waiting due to reasons within emergency complex.The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT

Background: Emergency Department (ED) of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients.

Aim: The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD).

Materials and methods: This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc.) of the emergency.

Results: Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be 9.00-12.00 h in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients under observation (29.6%); waiting for routine diagnostic tests (16.4%) and waiting for discharge (14.6%). Around 71% patients were waiting due to reasons within emergency complex.

Conclusion: The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

No MeSH data available.


Related in: MedlinePlus

Ground floor plan of emergency block of study institute in north India. A: Hall A Emergency Medical Out Patient Department (EMOPD); B: Hall B EMOPD; C: Emergency Surgical Out Patient Department; D: Waiting hall; E: Chemist shop; F: Laboratory; G: Ultrasonography room; H: X-ray room; I: Reception; J: Corridors; K: Waiting area for patients
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Figure 1: Ground floor plan of emergency block of study institute in north India. A: Hall A Emergency Medical Out Patient Department (EMOPD); B: Hall B EMOPD; C: Emergency Surgical Out Patient Department; D: Waiting hall; E: Chemist shop; F: Laboratory; G: Ultrasonography room; H: X-ray room; I: Reception; J: Corridors; K: Waiting area for patients

Mentions: The ED Block of the institute had a treatment area of approximately 23,088 square feet, which included 2 halls for patients with medical emergencies known as Emergency Medical OPD and one hall for patients with surgical emergencies known as Emergency Surgical OPD. The ED has one main entrance for patients and two more inlets from within the hospital, one from the main Hospital and one from advance trauma center. There is a cabin for enquiry adjoining main entrance where two receptionists along with one Assistant Public Relation Officer respond to the queries of the patients 24 × 7, along with other assigned works. There is a registration counter manned by one medical record technician, who register the patients, issued the gate passes to the patients’ attendants and mark “no payment stamp” on the recommendation form of patients after checking their eligibility. A fee clerk receives the hospital charges in a cabin adjoining to the registration counter. The fee counter runs from 8.00 to 20.00, after which that the collection of fees is done on the registration counter. There is a radiology room; attendant's waiting hall, laboratories, chemist shop, blood bank, toilets (male and female) and Senior Medical Officers (SMO's) room [Figure 1].


Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India.

Tiwari Y, Goel S, Singh A - J Emerg Trauma Shock (2014)

Ground floor plan of emergency block of study institute in north India. A: Hall A Emergency Medical Out Patient Department (EMOPD); B: Hall B EMOPD; C: Emergency Surgical Out Patient Department; D: Waiting hall; E: Chemist shop; F: Laboratory; G: Ultrasonography room; H: X-ray room; I: Reception; J: Corridors; K: Waiting area for patients
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126114&req=5

Figure 1: Ground floor plan of emergency block of study institute in north India. A: Hall A Emergency Medical Out Patient Department (EMOPD); B: Hall B EMOPD; C: Emergency Surgical Out Patient Department; D: Waiting hall; E: Chemist shop; F: Laboratory; G: Ultrasonography room; H: X-ray room; I: Reception; J: Corridors; K: Waiting area for patients
Mentions: The ED Block of the institute had a treatment area of approximately 23,088 square feet, which included 2 halls for patients with medical emergencies known as Emergency Medical OPD and one hall for patients with surgical emergencies known as Emergency Surgical OPD. The ED has one main entrance for patients and two more inlets from within the hospital, one from the main Hospital and one from advance trauma center. There is a cabin for enquiry adjoining main entrance where two receptionists along with one Assistant Public Relation Officer respond to the queries of the patients 24 × 7, along with other assigned works. There is a registration counter manned by one medical record technician, who register the patients, issued the gate passes to the patients’ attendants and mark “no payment stamp” on the recommendation form of patients after checking their eligibility. A fee clerk receives the hospital charges in a cabin adjoining to the registration counter. The fee counter runs from 8.00 to 20.00, after which that the collection of fees is done on the registration counter. There is a radiology room; attendant's waiting hall, laboratories, chemist shop, blood bank, toilets (male and female) and Senior Medical Officers (SMO's) room [Figure 1].

Bottom Line: The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients.Around 71% patients were waiting due to reasons within emergency complex.The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT

Background: Emergency Department (ED) of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients.

Aim: The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD).

Materials and methods: This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc.) of the emergency.

Results: Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be 9.00-12.00 h in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients under observation (29.6%); waiting for routine diagnostic tests (16.4%) and waiting for discharge (14.6%). Around 71% patients were waiting due to reasons within emergency complex.

Conclusion: The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

No MeSH data available.


Related in: MedlinePlus