Who Are the Children Leaving the Emergency Department Without Being Seen by a Physician?

Gaucher, Nathalie; Bailey, Benoît; Gravel, Jocelyn

doi:10.1111/j.1553-2712.2010.00989.x

Cited by 29 publications

(31 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6 It could be expected that with a higher proportion of patients who LWBS, sicker patients are leaving; therefore, higher rates of unfavourable outcome would be found, biasing our results toward a higher proportion of unfavourable outcome. The study was conducted in a single setting and should be replicated in multiple settings to improve generalizability.…”

Section: Discussionmentioning

confidence: 39%

“…[3][4][5][6] Recent publications report proportions of LWBS varying between 1 and 17%, with a mean of approximately 5%. 4,[6][7][8][9] As these patients may have important clinical outcomes, the rate of patients who LWBS has been considered one of the most important performance indicators for pediatric EDs. 10,11 There is very little information regarding the outcome of patients who LWBS and the morbidity engendered by the problem.…”

Section: Ré Sumémentioning

confidence: 99%

“…6 In brief, patients were triaged by a registered nurse using the Canadian Triage and Acuity Scale for children. 15 After variable waiting times, patients were evaluated by a physician.…”

Section: Study Protocolmentioning

confidence: 99%

See 2 more Smart Citations

Unfavourable outcome for children leaving the emergency department without being seen by a physician

Gravel

Gouin

Carrière

et al. 2013

CJEM

Self Cite

View full text Add to dashboard Cite

Objective: To assess the prevalence of an unfavourable outcome among children leaving without being seen by a physician in the emergency department (ED).Method: This was a prospective cohort study conducted over a complete year in a pediatric tertiary care ED. A random sample of all children younger than 19 years of age who left without being seen by a physician was contacted by phone 4 to 6 days following the ED visit. The primary outcome was the occurrence of an unfavourable outcome prospectively defined using a Delphi method among 15 pediatric emergency physicians. An unfavourable outcome was defined as hospitalization, the need for an invasive procedure (intravenous or intramuscular medication, fracture reduction, bone casting, or surgical intervention), suicide attempt, or death in the 72 hours following leaving without being seen by a physician. As a secondary outcome, multiple potential predictors were evaluated. The first analysis evaluated the proportion of unfavourable outcomes among children who left without being seen by a physician. Then logistic regression identified predictors of unfavourable outcomes. Results: During the study period, 61,909 children presented to the ED, 7,592 (12%) left without being seen by a physician, and 1,579 were recruited. Thirty-eight (2.4%; 95% CI 1.7-3.2) patients fulfilled the criteria for an unfavourable outcome. On multiple logistic regression, chief complaints related to trauma and absence of nurse counseling had higher risks of unfavourable outcome.Conclusions: Approximately 2% of children who left without being seen by a physician at a tertiary care pediatric ED had an unfavourable outcome. RÉ SUMÉObjectif: L'é tude visait à é valuer la pré valence des é vé nements dé favorables survenus chez les enfants qui quittent le service d'urgence (SU) sans avoir é té vus par un mé decin. Mé thode: Il s'agit d'une é tude de cohortes prospective, d'une duré e de 1 an, mené e dans un SU de soins tertiaires en pé diatrie. Un certain nombre d'enfants choisis au hasard, parmi tous ceux qui avaient moins de 19 ans et qui avaient quitté le SU sans avoir é té vus par un mé decin, ont é té joints par té lé phone, de 4 à 6 jours aprè s la demande de consultation. Le principal critè re d'é valuation consistait en la survenue d'é vé nements dé favorables, dé finis de maniè re prospective, à l'aide de la mé thode Delphi, par 15 pé diatres urgentologues. Les é vé nements dé favorables ont é té dé finis comme l'hospitalisation, la né cessité d'une intervention effractive (administration intraveineuse ou intramusculaire de mé dicaments, ré duction de fractures, pose d'un appareil plâ tré , intervention chirurgicale), une tentative de suicide, ou la mort dans les 72 heures suivant le dé part du SU sans examen pré alable par un mé decin. Quant au critè re d'é valuation secondaire, plusieurs facteurs pré visionnels possibles d'é vé nement dé favorable ont fait l'objet d'é valuation. La premiè re analyse visait à é valuer la proportion d'é vé nements dé favorables chez les enfants qui...

show abstract

Section: Discussionmentioning

confidence: 39%

Section: Ré Sumémentioning

confidence: 99%

See 1 more Smart Citation

Unfavourable outcome for children leaving the emergency department without being seen by a physician

Gravel

Gouin

Carrière

et al. 2013

CJEM

Self Cite

View full text Add to dashboard Cite

show abstract

“…O abandono prematuro da UP é frequentemente citado [1][2][3] como resultado da sobrelotação destes serviços por doentes sem critérios de observação urgente e que aumentam os tempos de espera. Para além do tempo de espera, outros aspectos referidos como facilitadores do abandono são a menor gravidade aferida na triagem e a proximidade da residência ao hospital.…”

unclassified

“…Para além do tempo de espera, outros aspectos referidos como facilitadores do abandono são a menor gravidade aferida na triagem e a proximidade da residência ao hospital. 1,4 Na literatura internacional, estão descritas, em séries pediátricas, percentagens de abandono que vão desde 1 a 15%. [5][6][7] Idealmente, esta percentagem devereria ser inferior a 2%.…”

unclassified

Crianças que Abandonam a Urgência Pediátrica: Oportunidades Perdidas?

et al. 2014

View full text Add to dashboard Cite

Introduction: Children who leave the Emergency Department may be at risk for preventable health problems related to the lack of timely assessment. Objective: The aim of this study was to evaluate and characterize the cases of children leaving our Emergency Department and to determine their clinical outcome. Material and Methods: A retrospective and descriptive review of the patient’s medical records was conducted. All children leaving the Emergency Department of Hospital de São Bernardo between January 1 and December 31, 2012, were included in the study. Results: A total of 538 children abandoned the Emergency Department (1.35 % of all admissions). The majority (89.5%) had no criteria for urgent assessment and abandoned before medical observation (82.7%). The percentage of leaving was higher in the months of December, January and February (64%), on Tuesday (19.3%) and in the afternoon shift (60.8%). These periods coincided with the peak inflow of patients to the Emergency Department. The waiting time for medical observation was in most cases (94.4%) appropriate to the clinical severity. Six patients returned within 72 hours, 2 requiring hospitalization. Discussion: The percentage of patients that walked-out from the Emergency Department was within the excepted range. A non-urgent triage level and prolonged waiting times were predisposing factors to abandonment. Conclusion: Overcrowding of the Emergency Department with children with non-urgent problems, that increase waiting times, can lead to abandonment with unfavorable outcome, which in our series occurred in only 2 cases. Keywords: Child; Patient Dropouts; Emergency Service, Hospital; Waiting Lists; Time Factors; Portugal.

show abstract

Patients leaving without being seen from the emergency department: A prediction model using machine learning on a nationwide database

Sheraton¹,

Gooch²,

Kashyap

2020

JACEP Open

View full text Add to dashboard Cite

show abstract

Who Are the Children Leaving the Emergency Department Without Being Seen by a Physician?

Abstract: Background: Waiting times to see a physician in emergency departments (EDs) are growing, and a greater number of patients are leaving the ED without being seen by a physician (LWBS).

Cited by 29 publications

References 29 publications

Unfavourable outcome for children leaving the emergency department without being seen by a physician

Unfavourable outcome for children leaving the emergency department without being seen by a physician

Crianças que Abandonam a Urgência Pediátrica: Oportunidades Perdidas?

Patients leaving without being seen from the emergency department: A prediction model using machine learning on a nationwide database

Contact Info

Product

Resources

About