Early Quick Acuity Score Provides More Complete Data on Emergency Department Walkouts
| Autor: | Daniel R. Brandt, Michael R. Minckler, J. Akiva Kahn, Stuart E. Greene, Matthew A. Bloch, Paris B Lovett |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Critical Care and Emergency Medicine Time Factors Non-Clinical Medicine Adolescent Statistics as Topic lcsh:Medicine Severity of Illness Index Treatment Refusal Young Adult Diagnostic Medicine Severity of illness Medical Sociology Medicine Quality of Care Humans Young adult Health Care Quality lcsh:Science Health Systems Strengthening Aged Demography Multidisciplinary Health Care Policy business.industry Mortality rate lcsh:R Health Services Administration and Management Patient Acuity Retrospective cohort study Emergency department Middle Aged Triage Socioeconomic Aspects of Health lcsh:Q Female Public Health business Behavioral and Social Aspects of Health Emergency Service Hospital Cohort study Research Article |
| Zdroj: | PLoS ONE PLoS ONE, Vol 9, Iss 1, p e85776 (2014) |
| ISSN: | 1932-6203 |
| Popis: | Introduction Many prior studies have compared the acuity of Emergency Department (ED) patients who have Left Without Being Seen (LWBS) against non-LWBS patients. A weakness in these studies is that patients may walk out prior to the assignment of a triage score, biasing comparisons. We report an operational change whereby acuity was assessed immediately upon patient arrival. We hypothesized more patients would receive acuity scores with EQAS. We also sought to compare LWBS and non-LWBS patient characteristics with reduced bias. Methods Setting: urban, academic medical center. Retrospective cohort study, electronic chart review, collecting data on all ED patients presenting between 4/1/2010 and 10/31/2011 (“Traditional Acuity Score” period, TAS) and from 11/1/2011 to 3/31/2012 (“Early Quick Acuity Score” period, EQAS). We recorded disposition (LWBS versus non-LWBS), acuity and demographics. For each subject during the EQAS period, we calculated how many prior ED visits and how many prior walkouts the subject had had during the TAS period. Results Acuity was recorded in 92,275 of 94,526 patients (97.6%) for TAS period, and 25,577 of 25,760 patients (99.3%) for EQAS period, a difference of 1.7% (1.5%, 1.8%). LWBS patients had acuity scores recorded in 5,180 of 7,040 cases (73.6%) during TAS period, compared with 897 of 1,010 cases (88.8%) during the EQAS period, a difference of 15.2% (14.8%, 15.7%). LWBS were more likely than non-LWBS to be male, were younger and had lower acuity scores. LWBS averaged 5.3 prior ED visits compared with 2.8 by non-LWBS, a difference of 2.5 (1.5, 3.5). LWBS averaged 1.3 prior ED walkouts compared with 0.2 among non-LWBS, a difference of 1.1 (0.8, 1.3). Conclusions EQAS resulted in a higher proportion of patients receiving acuity scores, particularly among LWBS. This offers more complete data when comparing LWBS and non-LWBS patient characteristics. The comparison reinforced findings from prior studies. |
| Databáze: | OpenAIRE |
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