Emergency department waiting room: many requests, many insured and many primary care physician referrals

Abstract

BackgroundIncrease in waiting time often results in patients leaving the emergency department (ED) without being seen, ultimately decreasing patient satisfaction. We surveyed low-acuity patients in the ED waiting room to understand their preferences and expectations.MethodsAn IRB approved, 42-item survey was administered to 400 adult patients waiting in the ED waiting room for >15 min from April to August 2010. Demographics, visit reasons, triage and waiting room facility preferences were collected.ResultsThe mean age of patients was 38.9 years (SD = 14.8), and 52.5% were females. About 53.8% of patients were employed, 79.4% had access to a primary care physician (PCP), and 17% did not have any medical insurance. The most common complaint was pain. A total of 44.4% respondents reported that they believed their problems were urgent and required immediate attention, prompting them to come to the ED, while 14.6% reported that they could not get a timely PCP appointment, and 42.9% were actually referred by their PCP to come to the ED. About 57.7% of patients considered leaving the ED if the waiting times were too long. The mean acceptable waiting time before leaving ED was 221 min (SD = 194; median 180 min, IQR 120–270). A total of 39.1% survey respondents reported being most comfortable being triaged by a physician. Respondents were least comfortable being triaged by residents. On analyzing waiting room expectations for the survey respondents, we found that 70% of the subjects wanted a better estimate of waiting time and 43.5% wanted better information on reasons for the long wait.ConclusionContrary to popular belief, at our ED a large proportion of low-acuity patients has a PCP and is medically insured. Providing patients with appropriate reasons for the wait, an accurate estimate of waiting time and creating separate areas to examine minor illness/injuries would increase patient satisfaction within our population subset.

Factors associated with patients’ and companions’ satisfaction with a hospital emergency department: A descriptive, cross‐sectional study

“…In our study, more than eight out of ten of the patients surveyed referred to pain when they visited the emergency department and in most cases, the pain was controlled completely or sufficiently. This result is similar to Kamali, Jain, Jain, and Schneider (), who found that more than half of all patients referred to having had some type of pain on arrival at the emergency department. In the present study, satisfaction with the service was not associated with the presence of pain but, rather, with the control of pain.…”

Why do Queenslanders seek care in emergency departments? A population study

“…Patients who perceived their condition as serious, either at the time of making the decision or while asked at the EDs, were more likely to use an ED repeatedly over the 6 month period. As established in previous reports, the perceived priority by patients themselves and the triage category assigned to them by clinical staff differed . However, the trend analysis of Queensland data interestingly showed an increase in more urgent triage categories and a decline in categories 4 and 5, and therefore the growth in demand appears to be among more urgent patients.…”

“…differed. [14][15][16][17] However, the trend analysis of Queensland data interestingly showed an increase in more urgent triage categories and a decline in categories 4 and 5, 18 and therefore the growth in demand appears to be among more urgent patients. Perceptions of urgency and seriousness were not the only issues of significance, as shown by the current study.…”

Étude des facteurs hospitaliers associés aux départs avant prise en charge médicale à l’urgence d’un centre hospitalier de soins tertiaires

“…En effet, les durées moyennes de séjour sont plus longues et le nombre moyen de DAPCM par jour est plus élevé au site HD qu'au site HF (p < 0,001 dans les deux cas). La durée moyenne de séjour des patients peut influencer le nombre de DAPCM 42 et nos régressions linéaires multiples indiquent que la durée moyenne de séjour des patients non hospitalisés à l'urgence dans notre éta-blissement est un déterminant important du nombre de DAPCM par jour puisqu'une augmentation d'une heure de la durée moyenne de séjour se traduit en une augmentation d'environ un patient DAPCM par jour pour les deux sites (Tableau 3).…”