Evaluation of Patient Flow and Waiting Time for the First Physician Visit in an Overcrowded Emergency Department

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
Hadi Yousefi ◽  
Fariba Asadi Noghabi ◽  
Samere Farhani Nejad ◽  
Mohsen Yousefi
Keyword(s):  
Emergency Department ◽  
Waiting Time ◽  
Physician Visit ◽  
Patient Flow ◽  
Demographic Data ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Average Waiting Time ◽  
Significant Difference ◽  
Patient Waiting Time

Background: The velocity of providing services in health centers is crucial to reduce mortality and adverse outcomes. Objectives: The present study aimed at determining the waiting time from entering the emergency department (ED) up to physician visiting based on congestion in the triple shift at Shahid Mohammadi Hospital in Bandar Abbas, Iran. Methods: The current cross-sectional, analytical study was conducted in 2019 on 1285 subjects selected from three shifts. The data collection tools included demographic data and standard triage forms, as well as a timetable with a stopwatch. The time between patient arrival and physician visit was recorded. SPSS software version 21 was employed to analyze the data. Results: The highest percentage of patients, 65.1% (n = 837), was non-traumatic, 38.98% (n = 501) referred during the evening shift, and 47.54% (n = 611) were related to the triage level 3. The maximum average waiting time from the beginning to the end of the triage was 4.46, and up to the physician, the visit was 12.8 minutes. Waiting time from entering ED up to physician first visit in terms of gender, refer to ED, and cause of referral statistically divulged a significant difference (P < 0.05). Estimation of the maximum congestion in the department was from 16:00 to 20:00, which showed a significant difference with other day times (P < 0.05). Conclusions: The average waiting time for patients was higher than the global standard. The interventions based on the maximum congestion in ED can be effective in reducing patient waiting time.

scholarly journals Measuring and Analyzing Waiting Time Indicators of Patients’ Admitted in Emergency Department: A Case Study

2015 ◽  
Vol 8 (1) ◽  
pp. 143 ◽  
Author(s):  
Saeed Amina ◽  
Ahmad Barrati ◽  
Jamil Sadeghifar ◽  
Marzeyh Sharifi ◽  
Zahra Toulideh ◽  
...  
Keyword(s):  
Emergency Department ◽  
Waiting Time ◽  
Waiting Times ◽  
Hospital Data ◽  
Governance System ◽  
Cross Sectional ◽  
Average Waiting Time ◽  
Study Population

<p><strong>BACKGROUND</strong><strong> </strong><strong>&amp;</strong><strong> </strong><strong>AIMS:</strong> Measuring and analyzing of provided services times in Emergency Department is the way to improves quality of hospital services. The present study was conducted with aim measuring and analyzing patients waiting time indicators in Emergency Department in a general hospital in Iran.</p> <p><strong>MATERIAL</strong><strong> </strong><strong>&amp;</strong><strong> </strong><strong>METHODS:</strong> This cross-sectional, observational study was conducted during April to September 2012. The study population consisted of 72 patients admitted to the Emergency Department at Baharlo hospital. Data collection was carried out by workflow forms. Data were analyzed by t.<strong> </strong>test and ANOVA.</p> <p><strong>RESULTS:</strong> The average waiting time for patients from admission to enter the triage 5 minutes, the average time from triage to physician visit 6 minute and the average time between examinations to leave ED was estimated 180 minutes. The total waiting time in the emergency department was estimated at about 210 minutes. The significant<strong> </strong>correlation between marital status of patients (P=0.03), way of arrive to ED (P=0.02) and type of shift work (P=0.01) with studied time indicators were observed.</p> <p><strong>CONCLUSION:</strong> According to results and comparing with similar studies, the average waiting time of patients admitted to the studied hospital is appropriate. Factors such as: Utilizing clinical governance system and attendance of resident Emergency Medicine Specialist have performed an important role in reducing of waiting times in ED.</p>

Assessment of Daily Burden and Factors for Overcrowded Emergency Department at Tertiary Care Hospital of Karachi

2021 ◽  
pp. 30-35
Author(s):  
Arsala Faridi ◽  
Farah Ahmad ◽  
Areej Zehra ◽  
Afreen Fazal
Keyword(s):  
Emergency Department ◽  
Emergency Room ◽  
Tertiary Care Hospital ◽  
Patient Flow ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Duration ◽  
Number Of Patients ◽  
Significant Difference

Background: When in emergency room there is no enough area left to serve or to admit the subsequent sick patients who may require urgent attention and observation the setting is called as the overcrowded emergency room. Due to overcrowded emergency department the quality of services provided by the staff and doctors is compromised ultimately patients with severe diseases are ignored and this may be one of the causes for causalities. Objective: To assess the daily burden and factors responsible for overcrowding at emergency department of tertiary care hospital of Karachi. Methodology: It was a cross sectional study conducted at tertiary care hospital of Karachi from October 2020 to January 2021. Data of patients coming to adult emergency department of either gender were collected.  Patients age <14 were excluded as these were referred to pediatric emergency department. Data collection was done according to Canadian emergency department triage and acuity scale (CTAS). Results: Total number (N) of patients who visited emergency department in study duration was 13434. The mean number of patients who visited ED was 141±13during our study duration. There was no any significant difference in presenting complaint. Delay in investigations was found to be a reason of prolong stay and overcrowding in ED in our setting. Conclusion: Overcrowding of patients in our ED of our setting was a common problem. The number of staff, doctors and beds were not matching the number of patient flow in the department. The main reason of prolong stay in ED was delay in investigations.

scholarly journals FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN WAITING TIME PADA PASIEN TRIAGE KUNING

2020 ◽  
Vol 4 (1) ◽  
pp. 14-25
Author(s):  
Milda Aprilian Sari ◽  
Susi Erianti ◽  
Erna Marni
Keyword(s):  
Emergency Department ◽  
Laboratory Test ◽  
General Hospital ◽  
Waiting Time ◽  
Check List ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Associated ◽  
Patient Waiting Time ◽  
Patient Waiting

  Abstrak Waiting time diartikan rentang waktu kedatangan pasien emergency yang diukur mulai dari pasien datang sampai ditransfer keruangan lain. Penumpukan pasien (overcrowded) merupakan masalah yang sering terjadi di Instalasi Gawat Darurat yang dapat menyebabkan waktu tunggu yang lama. Waktu tunggu yang baik dapat meningkatkan mutu pelayanan dan kepuasan yang lebih kepada pasien. Tujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan dengan waiting time pada pasien triage kuning di IGD RSUD Arifin Achmad Provinsi Riau. Desain yang digunakan dalam penelitian ini adalah observasional analitik dengan pendekatan cross sectional. Sampel dalam penelitian ini adalah pasien yang masuk IGD pada triage kuning dengan teknik pengambilan sampel menggunakan concecutive sampling sebanyak 85 responden. Instrumen penelitian menggunakan lembar observasi dan metode Check List. Hasil  bivariat dengan uji chi-square didapatkan bahwa dari empat faktor yang dianalisa terdapat faktor yang berhubungan dengan waiting time adalah waktu kembalinya hasil pemeriksaan laboratorium. Sedangkan faktor-faktor yang tidak berhubungan dengan waiting time pada pasien triage kuning yaitu rasio perbandingan perawat dengan pasien pershift, sarana prasarana, dan adminstrasi. Diharapkan kepada pihak manajemen RSUD Arifin Achmad Provinsi Riau untuk terus mengontrol performa pelayanan pada pemeriksaan penunjang yaitu waktu tunggu kembalinya hasil pemeriksaan laboratorium agar tidak melebihi standar yang telah ditetapkan oleh rumah sakit sehingga dapat mengurangi waktu boarding pasien yang memanjang.   Kata kunci: Pasien triage kuning, Waiting Time   Factors Associated with Yellow Triage Patients’ Waiting Time   Abstract   Waiting time refers to time span of emergency patients has to spend, starting from patient’s arrival to patient being transferred to another room. Overcrowding is a common problem faced at emergency department causing longer waiting time for patients.  Shorter waiting time can improve quality of service and patients’ level of satisfaction. This study was aimed to determine factors associated with yellow triage patients’ waiting time at emergency department of Arifin Achmad General Hospital of Riau Province. This observational-analytic study was carried out using cross sectional approach. Samples of this study were patients entering Emergency Department with yellow triage category, with 85 respondents who were recruited using consecutive sampling technique. Observation sheet and check list method were used as the study instruments. The result of univariate and bivariate analyses using Chi-square test showed that of all four analyzed factors associated with patient waiting time, the most significantly related one was waiting time for laboratory test results. In contrast, the least related factors were nurse-patient ratio per shift, facilities and infrastructures, and administration procedure. It is expected that the management of Arifin Achmad General Hospital of Riau Province to maintain control of the service performance on supporting examination, especially waiting time for the laboratory test result, which will reduce the amount of patient boarding time which keeps extending.   Keywords: Yellow triage patient, Waiting Time  

scholarly journals Quality-driven framework for reducing patient waiting time in emergency department

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Neven Saleh ◽  
◽  
Hend Adel ◽  
Manal Abdel Wahed ◽  
◽  
...  
Keyword(s):  
Emergency Department ◽  
Waiting Time ◽  
Quality Function Deployment ◽  
Emergency Department Patient ◽  
Quality Function ◽  
Average Waiting Time ◽  
Paired Samples ◽  
Technical Requirements ◽  
Patient Waiting Time ◽  
Patient Waiting

Emergency department is the first admission point for urgent patients. It is characterized by the overcrowding due to the functional operations of this department. Indeed, sometimes one minute for an emergency department patient means life sustainability. One form to cope with the overcrowding problem is to reduce patient waiting time. Therefore, the study aims to reduce the average waiting time for all types of emergency department patients by using quality function deployment. It starts with involvement of all stakeholders within the department. The stakeholders include patients, nurses, doctors, and clinical engineers. The framework was designed through six steps, commencing with customer (patients) requirements identification, and concluding with the weights of technical requirements. The model has been applied on 2 hospitals. Paired samples t-test results reveal a significant reduction in the average waiting time, increasing the served patients and improving the quality of emergency department services. The main contribution of this article is utilizing the quality function deployment as a new methodology in resolving the overcrowding problem in emergency department.

Parent’s Experiences from the Treatment of their Children at the Physic Children’s Surgery Clinic in Skopje.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
M. Trajchevska ◽  
A. Lleshi ◽  
S. Gjoshev ◽  
A. Trajchevski
Keyword(s):  
Health Care ◽  
Health Status ◽  
Independent Predictor ◽  
Demographic Data ◽  
Parental Satisfaction ◽  
Pediatric Care ◽  
Simple Random Sample ◽  
Significant Independent Predictor ◽  
Cross Sectional ◽  
Significant Difference

Background: The respect of the needs and wishes of the patients is in the focus of the human health system. The experience of the parents in terms of child’s health care may be used as an indicator of quality of the health care. Material and methods: The research is a quantitative analytical cross-sectional study. In accordance with the inclusion and exclusion criteria, simple random sample of 207 parents / guardians is covered, whose children in the period of three months, had been hospitalized in the hospital department JZUU Pediatric Surgery Clinic in Skopje.It was used a two parted questionnaire. The first part is a standardized questionnaire (Parent Experience of Pediatric Care - PECP), and the second part concerns the general socio-demographic data of the parent/guardian. Statistical evaluation was performed using appropriate statistical programs (Statistics for Windows 7,0 and SPSS 17.0). Results: In accordance with the age of the parents, the survey respondents were divided into two groups: a) age ≤ 33 years - 107 (51.69%) and b) age> 33 years - 100 (48.31%).Significant independent predictor of parental satisfaction from the receipt of their child to the clinic research confirms the age of the parent under / over 33 years due to 4.1% of the change in satisfaction (R2 = 0,041). Parents generally believe that their children's room of the clinic is "good", without significant difference between parental satisfaction from both age groups (Mann-Whitney U Test Z = -0,9613 p = 0,3364). Significant independent predictor of parental satisfaction from the room of their child improves the health status after treatment due to 6% of the change in satisfaction (R2 = 0,060). Parents generally believe that testing and treatment of their children in the clinic was "very good" and an independent significant predictor is to improve the health status after the treatment - 7,8% (R2 = 0,078). Conclusions: Regardless of the generally good parental satisfaction about health care for their children, it is necessary to continuously monitor the status of the clinic in order to consider the possible deficiencies and needs of intervention.

scholarly journals Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

2021 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Older Children ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

scholarly journals Prevalence of Urinary Schistosomiasis among Almajiri Children in Silame, Sokoto State, North-western Nigeria

2021 ◽  
Vol 6 (1) ◽  
pp. 99-104
Author(s):  
S. M. Gamde ◽  
◽  
P. J. Tongvwam ◽  
K. Hauwa ◽  
A. M. Ganau ◽  
...  
Keyword(s):  
Demographic Data ◽  
Age Groups ◽  
Water Contact ◽  
Cross Sectional ◽  
Urinary Schistosomiasis ◽  
Public And Private ◽  
Significant Difference ◽  
Socio Demographic Factors ◽  
Age Range ◽  
North Western

Urinary schistosomiasis is a severe threat to global health with uncountable morbidities in Africa including Nigeria where control interventions focused on children in public and private schools neglecting Almajiri children. This undermined control interventions as those infected contaminate the environments with infective stages of the parasite. The objective of the study was to identify the prevalence of urinary schistosomiasis amongst Almajiri children in Silame, Sokoto State, North-western Nigeria. This was a cross-sectional descriptive study, socio-demographic data was collected in April 2020 on 206 consented Almajiri children in Silame and their urine samples were examined using the sedimentation method. The study showed a prevalence of 35.4% among the Almajiri children in Silame, Sokoto State, North-western Nigeria. The highest prevalence was found among children within the age range 16-20 years (63.6%) while the lowest prevalence was among those in the age range 6-10 years (24.4%). There was a statistically significant difference in the occurrence of urinary schistosomiasis between the age groups (χ 2 = 11.637a , df =3, p=0.002). Urinary schistosomiasis was prevalent among Almajiri children in the study area and parasite infection was associated with the participant's socio-demographic factors such as age, level of education, and water contact activities. Hence, the National Schistosomiasis Control Programs should incorporate the Almajiri children in the control interventions Keywords: Schistosoma hematobium infection; Makarantarallo;Almajiri;Silame

scholarly journals Comparison of sensorineural hearing loss characteristics in different hemodialysis vascular accesses

2020 ◽  
Author(s):  
Behieh Kohansall ◽  
Nasser Saeedi ◽  
Moeinoddin Hossein Beigi ◽  
Azam Moslemi ◽  
Akram Valizadeh
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Vascular Access ◽  
Demographic Data ◽  
Life Quality ◽  
Cross Sectional Study ◽  
Sensorineural Hearing ◽  
Moderate Degree ◽  
Cross Sectional ◽  
Significant Difference

Background and Aim: Sensorineural hearing loss (SNHL) is one of the complications in hemodialysis patients. Vascular access (VA) represents a lifeline for these patients affecting their life quality and clinical outcomes. Arterio­venous fistula is the gold standard of VAs with minor complications and better hemodialysis adequacy. There is no study investigating hearing differences in hemodialysis VAs. Hence, this study aimed to compare SNHL characteristics amongst hemodialysis VAs. Methods: This cross-sectional study conducted on 64 patients aged 18−60 years received regular hemodialysis in 2019. Demographic data and comorbid conditions were recorded based on patients’ case records and electronic databases. After a physical examination, otoscopy, tympa­nometry, and conventional audiometry, patients were divided into fistula (n = 26), permanent catheter (n = 36), and temporary catheter (n = 2) groups according to vascular access type. Results: Prevalence rate of SNHL was 63.89%, 50% and 50% in the permanent catheter, fistula and temporary catheter groups, respectively. Most patients had mild sloping-SNHL in the per­manent catheter and fistula groups as against moderate degree in the other group. There was no significant difference in hearing thresholds, deg­ree and audiogram shape among VA groups. No significant relation was found between age, sex, hemodialysis duration and disease duration with hearing loss in all groups (p > 0.05). Conclusion: More patients had SNHL in per­manent catheter group. Vascular access types, longer duration of hemodialysis and disease dur­ation do not seem to be associated with SNHL. However, further investigation is needed to cla­rify the relationship. Keywords: Sensorineural hearing loss; vascular access; chronic renal failure; hemodialysis

scholarly journals The Latent Tuberculin Test after 1-year Therapy with Anti-TNF in Babylon, Iraq

2018 ◽  
Vol 26 (8) ◽  
pp. 144-150
Author(s):  
Ali Alkazzaz ◽  
Murtadha Najah Jawad ◽  
Zeyad Tareq Kareem
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Medical History ◽  
Demographic Data ◽  
Latent Tuberculosis ◽  
Tuberculin Test ◽  
P Value ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference

Background: Rheumatoid arthritis (RA) patients receiving receive anti-TNF agents are at increased risk of reactivation of latent tuberculosis infection (LTBI). The tuberculin skin test (TST) is widely used to screen LTBI and providing preventive treatment, in an effort to meet the WHO target of a 90% reduction in TB by 2035. Objectives: To determine the proportion of TST conversion among RA patients after 1 year of anti-TNF treatment and association of positive TST result with patients’ socio-demographic characteristics and medical history. Methods: This community-based cross-sectional study was conducted at the Department of Rheumatology of Marjan Teaching Hospital in Iraq, for a period of 1 year. Patients with RA/and spondyloarthropathy, and who received anti-TNF therapy for >1 year, underwent TST. Their demographic data and medical history were also obtained. All statistical analysis was performed using SPSS (Version 20) and, p < 0.05 was considered as a sign. Data from the baseline and 1 year follow-up was subjected to the Kolmogorov-Smirnov test to determine whether they were normally distributed. Chi-Square test used to test significance of TST among etanrecept and infliximab at the end of the study. Results: A total of 96 patients were enrolled, including 55 (57.3%) males and 41 (42.3%) females with an average age of 41.1, and mostly 68 (70.8%) from Babylon Governorate of Iraq. A total of 40 (41.7%) patients had rheumatoid arthritis alone, and the remaining 56 (58.3%) had a comorbidity of spondyloarthropathy. Majority of the patients 65 (67.7%) received the biological agent infliximab, while 31 (32.3%) patients received Etanercept for RA for a period of 1 year. There was a statistically significant decreasing in the median ESR and disease activity  from the baseline to the end of the study (p-value <0.01). There was no significant difference in TST results based on gender or age. Both infliximab and etanercept were significantly associated with a decreasing  in ESR and disease activity Conclusion: This study has shown that there was very low TST conversion among RA patients after 1 year of anti-TNF treatment and, age and gender were not associated with TST.

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