Characterization of emergency department abandonment using a real-time location system

Geers, Jenna M.; Pasupathy, Kalyan S.; Lovik, K.; Finley, Janet L.; Hellmich, Thomas; Marisamy, Gomathi; Nestler, David M.; Sadosty, Annie T.; Sir, Mustafa Y.; Heaton, Heather A.

doi:10.1016/j.ajem.2019.06.025

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…14,15 To achieve this, quantitative evaluations through digital modes are preferable. 16,17 The demand for additional services, namely reservation systems to see a doctor, medical interview applications (e.g., smartphone app), and home visitation services, are high.…”

Section: Discussionmentioning

confidence: 99%

Survey on emergency care utilization in tertiary care hospitals in Indonesia

Fujisawa,

Fukaguchi,

Tokita

et al. 2024

Preprint

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Objective: Indonesia's emergency care system remains suboptimal despite rising demand due to socio-economic changes and increased life expectancy. This study aims to examine patient and family perceptions of the current emergency care system, identify potential needs, and provide a foundation for its development and improvement. Methods: This cross-sectional study used an online survey at two Indonesian hospitals in 2022 to target adult emergency department patients or their families. Each participant's demographic data, patient journey details, and potential additional medical services were analyzed using descriptive statistics. Results: The study included 446 participants, primarily family members of patients (93.7%), with a median age of 37 (IQR: 28 to 43 years). The majority of patients visited the hospital using private cars (36.9%) and taxis (17.2%), with marked variation between the two hospitals. Only 9.4% of participants were aware of Public Safety Center (PSC) services, and the majority (58.9%) did not use them because they did not know how to contact PSC. The most common waiting time was up to 20 minutes at two tertiary care hospitals. Additional services desired by participants included doctor reservation systems, medical interview applications, and home visitation services. Reported problems included long waiting times and crowded emergency rooms. Conclusions: The study highlights transportation disparities and the demand for supplemental services to better emergency department experiences. For optimizing PSC utilization and future resource distribution, it is vital to further investigate patient behaviors and needs during emergency department visits.

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Section: Discussionmentioning

confidence: 99%

Survey on emergency care utilization in tertiary care hospitals in Indonesia

Fujisawa,

Fukaguchi,

Tokita

et al. 2024

Preprint

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“…However, utilization of RTLS and alternative real-time data streams, such as physiologic monitoring data, is increasing. 16 Geers et al 17 found RTLS to be an efficient and effective way to measure “left without being seen” rates. Other innovative projects have used passive tracking to measure naloxone kit penetrance into the community.…”

Section: Discussionmentioning

confidence: 99%

Improving Care Delivery: Location Timestamps to Enhance Process Measurement of a Clinical Workflow

Barrick

Frey

et al. 2021

Pediatric Quality &Amp; Safety

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“…[4] Other investigators have assessed LWBS by using a timestamp indicating when the patient last had contact with a care provider. [8] Best practice suggests that the LWBS rate be less than 2%, but starting in the summer of 2020 during the COVID-19 pandemic, our community hospital ED experienced a rate of greater than 5%. [9] Patient volume increased exponentially during the pandemic as the Delta variant surged, overtaxing an already limited number of available beds.…”

Section: Introduction 11 Backgroundmentioning

confidence: 99%

Reducing “Left without being seen” in a community emergency department: A rapid-cycle change project

McBroom

Elliott²,

Cockerham³

et al. 2023

JNEP

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Background and objective: The COVID-19 pandemic in 2020 increased the volume of patients seeking care in the Emergency Department (ED) for a respiratory crisis. Our community hospital experienced a filling of inpatient beds, leading to an overflow of admitted patients in the ED, where adequate staff (nurses, physicians, radiology, and laboratory staff), equipment, and rooms or places for patients were lacking. Times to obtain procedures that included cardiology, laboratory, and radiology performed and resulted significantly increased. Left without being seen (LWBS) is a challenge faced by EDs across the United States (US) and has become more prevalent since the COVID-19 pandemic. Best practice suggests an LWBS rate of less than 2%, but our hospital experienced an increasing rate of hitting over 5\% in January 2021. To reduce this rate, we implemented multiple rapid-cycle Plan-Do-Check-Act (PDCA) change interventions in triage and throughout the ED.Implementation/Methods: We implemented several rapid-cycle change interventions with a high-level action plan. These actions included hiring medical/surgical nurses to care for admitted patients awaiting beds, adding additional medical providers, implementing greeters, creating specialty chairs inside a major hospital thoroughfare, opening a 12-bed Admit Care Unit (ACU) adjacent to the ED, and more.Results: The rate of LWBS decreased from a high of 5.3% in January 2021 to 1.09% in January 2022.Conclusion/Implications to Practice: Patients in the ED recorded as LWBS are at higher risk for safety and quality transgressions. We continue to work toward excellent patient care by continuing to implement rapid-cycle changes in response to barriers as they arise. More research is needed to expand and rethink the process of ED throughput during pandemics and emergent national crises.

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Characterization of emergency department abandonment using a real-time location system

Cited by 7 publications

References 16 publications

Survey on emergency care utilization in tertiary care hospitals in Indonesia

Survey on emergency care utilization in tertiary care hospitals in Indonesia

Improving Care Delivery: Location Timestamps to Enhance Process Measurement of a Clinical Workflow

Reducing “Left without being seen” in a community emergency department: A rapid-cycle change project

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