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Reasons for delay in inpatient admission at an emergency department

Mohammad A Tashkandy1, Zohair Jamil Gazzaz, Mian Usman Farooq

  • 1Al-Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia.

Journal of Ayub Medical College, Abbottabad : JAMC
|November 26, 2008
PubMed

Insights

Sixty-seven percent of admitted patients experienced prolonged stays in the Emergency Department (ED). Delays were primarily caused by late admission advice and multiple consultations, impacting patient flow.

Area of Science:

  • Emergency Medicine
  • Healthcare Management
  • Patient Flow Optimization

Background:

  • Prolonged Emergency Department (ED) stays for admitted patients represent a significant challenge in healthcare systems.
  • Understanding the root causes of these delays is crucial for improving patient care and operational efficiency.

Purpose of the Study:

  • To identify and analyze the key factors contributing to extended patient stays in the ED among those advised for admission.
  • To differentiate delay causes occurring before and after the admission decision.

Main Methods:

  • Retrospective review of 4876 patient records at Al-Noor Specialist Hospital, Makkah, Saudi Arabia.
  • Analysis of demographic data and clinical notes to determine reasons for prolonged ED length of stay (LOS).
  • Defined prolonged LOS as >2 hours from arrival to ward reception; categorized delays into Group A (before admission advice) and Group B (after).

Main Results:

  • Out of 355 admitted patients, 238 (67%) experienced delayed admission.
  • The mean LOS for delayed patients was 256 minutes.
  • Common delay reasons included multiple consultations and further investigations (48% in Group A) and file-making processes (43.5% in Group B).

Conclusions:

  • A significant majority (67%) of admitted patients faced delays in the ED.
  • Late admission advice and the necessity for multiple consultations were identified as primary drivers of these prolonged stays.
  • Addressing these bottlenecks, particularly consultation processes, is essential for improving ED patient flow.
Abstract

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