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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.


Waiting time distribution of patients for various services in the Emergency Out Patient Department of study institute; A: Waiting time attributed to reasons within the Emergency Department (ED) complex; B: Waiting time attributed to reasons outside the ED but within hospital; C: Waiting time attributed to reasons outside hospital
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Figure 3: Waiting time distribution of patients for various services in the Emergency Out Patient Department of study institute; A: Waiting time attributed to reasons within the Emergency Department (ED) complex; B: Waiting time attributed to reasons outside the ED but within hospital; C: Waiting time attributed to reasons outside hospital

Mentions: It was observed that maximum patients (29.6%) were waiting “under observation” after preliminary diagnosis by the physician and their median waiting time was 16 h. The next highest category of patients (16.4%) was those who were waiting for “diagnostics tests and their results” with the median waiting time as 1 h. The number of patients, who had completed the treatment process and waiting for doctors decision regarding discharge from EOPD was also substantial (14.6%) with the median waiting time of 2 h. Maximum median waiting time (38 h) was recorded for patients waiting for their turn for operative procedure after the decision to operate. It was observed that waiting of around 71% of patients in EOPD was attributed to factors within ED itself, whereas waiting of 26% patients was attributed to the reasons outside ED but within hospital [Figure 3].


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)

Waiting time distribution of patients for various services in the Emergency Out Patient Department of study institute; A: Waiting time attributed to reasons within the Emergency Department (ED) complex; B: Waiting time attributed to reasons outside the ED but within hospital; C: Waiting time attributed to reasons outside hospital
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Waiting time distribution of patients for various services in the Emergency Out Patient Department of study institute; A: Waiting time attributed to reasons within the Emergency Department (ED) complex; B: Waiting time attributed to reasons outside the ED but within hospital; C: Waiting time attributed to reasons outside hospital
Mentions: It was observed that maximum patients (29.6%) were waiting “under observation” after preliminary diagnosis by the physician and their median waiting time was 16 h. The next highest category of patients (16.4%) was those who were waiting for “diagnostics tests and their results” with the median waiting time as 1 h. The number of patients, who had completed the treatment process and waiting for doctors decision regarding discharge from EOPD was also substantial (14.6%) with the median waiting time of 2 h. Maximum median waiting time (38 h) was recorded for patients waiting for their turn for operative procedure after the decision to operate. It was observed that waiting of around 71% of patients in EOPD was attributed to factors within ED itself, whereas waiting of 26% patients was attributed to the reasons outside ED but within hospital [Figure 3].

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.