Factors related with length of stay more than 8 hours at the Emergency Department of Bhumibol Adulyadej Hospital
Keywords:
Length of stay, Overcrowding, Emergency roomAbstract
Background: Emergency department plays an important role in patient care. Time is very crucial in the ER. But in today setting, the department is faced with patient overcrowding which leads to other problems, such as patient congestion and decreased working efficiency, which can ultimately result in mistreatment. Since timing is very important, to study the factors that increase the time patients spend in ER can lead to better management and improve the quality of health services.
Aim:To study factors that cause the non-traumatic patients to spend more than 8 hours in the emergency room of BhumibolAdulyadej Hospital.
Methods:Patients will be classified into 2 groups of 500 each. One group consists of patients who had spent more than 8 hours, and another, equal to or less than 8 hours in the ER. The data will be collected via medical recordand statistical analysis will be performed by logistic regression
Results:Factors that cause non-traumatic patient to spend time more than 8 hours in the ER are: 1) Imaging study (OR 21.612 (95% CI 9.731,47.990), 2) Arrival time at 16.00-24.00 shifts (OR 2.831 (95% CI 1.670, 4.798), and 3) Specialist consultation (OR 21.699 (95% CI 7.300, 64.501)
Conclusion: Time spent for imaging study, arrival at evening shift (16.00-24.00), and specialist consultation are the leading causes that make the patients spent more than 8 hours in the ER at our institute. Future study should be done to address the specific issues in each factors in order to improve the healthcare system in the ER.
References
Canadian Association of Emergency Physicians.Overcrowding. [Website].; 2003 [cited 2017 Febuary 2.
The American College of Emergency Physicians. Emergency Medicine Crowding and Boarding. [Website].; 2013 [cited 2017 Febuary 16.
Department of Health for National Health Service acute hospitals in England. [Website].; 2010 [cited 2017 Febuary 18.
Mooney H. Admissions from emergency departments rise as four hour target approaches. BMJ [Internet]. BMJ; 2009 Nov 19;339(nov19 2):b4931–b4931.
NHS England, A&E Attendances and Emergency Admissions. A&E waiting times. [Website].; 2016 [cited 2017 Febuary 18.
Asplin BR, Magid DJ, Rhodes KV, Solberg LI, Lurie N, Camargo CA. A conceptual model of emergency department crowding.Annals of Emergency Medicine [Internet]. Elsevier BV; 2003 Aug;42(2):173–80.
Singer AJ, ThodeJr HC, Viccellio P, Pines JM. The Association Between Length of Emergency Department Boarding and Mortality. Academic Emergency Medicine [Internet]. Wiley-Blackwell; 2011 Dec;18(12):1324–9.
The British Medical Association. BMA survey of accident and emergency waiting times, March 2005. [Website].; 2005 [cited 2017 Febuary 18.
Zaman MJ. Four hour target for emergency departments isn’t clinically sound. BMJ [Internet]. BMJ; 2017 Feb 10;j737.
Proportion of trusts missing four-hour target more than doubles. Emergency Nurse [Internet]. RCN Publishing Ltd.; 2013 Apr;21(1):4–4.
Hughes G. The four hour target; problems ahead. Emergency Medicine Journal [Internet]. BMJ; 2006 Jan 1;23(1):2–2.
Bukhari H, Albazli K, Almaslmani S, Attiah A, Bukhary E, Najjar F, et al. Analysis of Waiting Time in Emergency Department of Al-Noor Specialist Hospital, Makkah, Saudi Arabia. Open Journal of Emergency Medicine. Scientific Research Publishing, Inc,; 2014;02(04):67–73.
Chaou C-H, Chiu T-F, Yen AM-F, Ng C-J, Chen H-H. Analyzing Factors Affecting Emergency Department Length of Stay—Using a Competing Risk-accelerated Failure Time Model. Medicine [Internet]. Ovid Technologies (Wolters Kluwer Health); 2016 Apr;95(14):e3263.
AlMulhim DA, Saddik B. Factors Influencing Patient Waiting Time as Key Performance Indicator of the Emergency Department Services at National Guard Health Affairs-Dammam Hospital. Public Health Frontier [Internet]. The World Academic Publishing; 2015 Jun 30;4(2):7–17.
SeyedMohammadHosseininejad et al. Determinants of Prolonged Length of Stay in the Emergency Department.; 2017 January 18; 5(1): 1-7.
อรรถสิทธิ์ อิ่มสุวรรณ, อินทนนท์ อิ่มสุวรรณ. การศึกษาปัจจัยที่มีผลต่อระยะเวลาการรับบริการในห้องฉุกเฉินนานกว่า 4 ชั่วโมงของโรงพยาบาลธรรมศาสตร์เฉลิมพระเกียรติ. ธรรมศาสตร์เวชสาร558;15:39-49.
กมลวรรณเอี้ยงฮง. ปัจจัยที่ความสัมพันธ์กับระยะเวลาของผู้ป่วยในห้องฉุกเฉินเกิน 4 ชมโรงพยาบาลศรีนครินทร์. ศรีนครินทร์เวชสาร 2557; 29 (1): 7-13.
Aphinives (Jiamprasert) V (Sutasinee), Hurst CP, Sriprajittichai P. Factors Associated with Length of Stay of Non-Trauma Patients in the Emergency Department: A Cross-Sectional Study in Thai Healthcare Setting. JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND. 2017;100(11):1232.
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