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Avoiding prolonged waiting time during busy periods in the emergency department: Is there a role for the senior emergency physician in triage?
Eur J Emerg Med. 2006 Dec; 13(6):342-8.EJ

Abstract

STUDY OBJECTIVE

Patient satisfaction at emergency departments can be improved by reductions in waiting time. Traditional methods require registration and triage before seeing the doctor with senior emergency physicians mainly engaged in treating serious cases. We examine a radical change in workflow pattern on waiting time by placing a senior emergency physician with the triage nurse and examining the impact of treating simple cases upfront with discharge on the waiting times for stretcher cases.

METHODS

A senior emergency physician was placed with the triage nurse in the Department of Emergency Medicine at Alexandra Hospital during peak busy periods of patient attendance over a period of 2 months. Measures were made of waiting time (registration to doctor consult) of PACS 3 and PACS 2 (Patient Acvity Score) cases accordingly.

RESULTS

Ten days were chosen for the changed workflow practice and 10 days for controls in which normal traditional working practice followed. On all days, there was the same number of medical staff. The average waiting time for walk-in patients (PACS 3) was 19 min on experimental days as compared with 35.5 min on control days, with 78% being seen within 30 min in the experimental group compared with 48% on control days (P < 0.05). The PACS 2 waiting time was also significantly decreased on experimental days (P < 0.05).

CONCLUSIONS

Placing a senior emergency physician with the triage nurse reduced waiting times for walk-in cases. One third of attendances were treated and discharged quickly, allowing the consulting room and PACS 1/PACS 2 doctors to act more efficiently.

Authors+Show Affiliations

Department of Emergency Medicine, Alexandra Hospital, Singapore, Republic of Singapore. james_travers@alexhosp.com.sqNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

17091056

Citation

Travers, James P., and Francis C Y. Lee. "Avoiding Prolonged Waiting Time During Busy Periods in the Emergency Department: Is There a Role for the Senior Emergency Physician in Triage?" European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, vol. 13, no. 6, 2006, pp. 342-8.
Travers JP, Lee FC. Avoiding prolonged waiting time during busy periods in the emergency department: Is there a role for the senior emergency physician in triage? Eur J Emerg Med. 2006;13(6):342-8.
Travers, J. P., & Lee, F. C. (2006). Avoiding prolonged waiting time during busy periods in the emergency department: Is there a role for the senior emergency physician in triage? European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, 13(6), 342-8.
Travers JP, Lee FC. Avoiding Prolonged Waiting Time During Busy Periods in the Emergency Department: Is There a Role for the Senior Emergency Physician in Triage. Eur J Emerg Med. 2006;13(6):342-8. PubMed PMID: 17091056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Avoiding prolonged waiting time during busy periods in the emergency department: Is there a role for the senior emergency physician in triage? AU - Travers,James P, AU - Lee,Francis C Y, PY - 2006/11/9/pubmed PY - 2007/1/12/medline PY - 2006/11/9/entrez SP - 342 EP - 8 JF - European journal of emergency medicine : official journal of the European Society for Emergency Medicine JO - Eur J Emerg Med VL - 13 IS - 6 N2 - STUDY OBJECTIVE: Patient satisfaction at emergency departments can be improved by reductions in waiting time. Traditional methods require registration and triage before seeing the doctor with senior emergency physicians mainly engaged in treating serious cases. We examine a radical change in workflow pattern on waiting time by placing a senior emergency physician with the triage nurse and examining the impact of treating simple cases upfront with discharge on the waiting times for stretcher cases. METHODS: A senior emergency physician was placed with the triage nurse in the Department of Emergency Medicine at Alexandra Hospital during peak busy periods of patient attendance over a period of 2 months. Measures were made of waiting time (registration to doctor consult) of PACS 3 and PACS 2 (Patient Acvity Score) cases accordingly. RESULTS: Ten days were chosen for the changed workflow practice and 10 days for controls in which normal traditional working practice followed. On all days, there was the same number of medical staff. The average waiting time for walk-in patients (PACS 3) was 19 min on experimental days as compared with 35.5 min on control days, with 78% being seen within 30 min in the experimental group compared with 48% on control days (P < 0.05). The PACS 2 waiting time was also significantly decreased on experimental days (P < 0.05). CONCLUSIONS: Placing a senior emergency physician with the triage nurse reduced waiting times for walk-in cases. One third of attendances were treated and discharged quickly, allowing the consulting room and PACS 1/PACS 2 doctors to act more efficiently. SN - 0969-9546 UR - https://www.unboundmedicine.com/medline/citation/17091056/Avoiding_prolonged_waiting_time_during_busy_periods_in_the_emergency_department:_Is_there_a_role_for_the_senior_emergency_physician_in_triage L2 - https://doi.org/10.1097/01.mej.0000224425.36444.50 DB - PRIME DP - Unbound Medicine ER -