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Setting wait times to achieve targeted left-without-being-seen rates
Jared Lucas1, Robert J Batt2, Olanrewaju A Soremekun3
1Perlman School of Medicine, University of Pennsylvania, Philadelphia, PA.
The American Journal of Emergency Medicine
|March 4, 2014
Summary
Reducing emergency department (ED) wait times is crucial for lowering leave-without-being-seen (LWBS) rates. Target wait times for patients with lower triage acuity levels, such as Emergency Severity Index (ESI) 3 and 4/5, should be under 45 and 60 minutes, respectively, to achieve a 2% LWBS rate.
Area of Science:
- Emergency Medicine
- Healthcare Operations Research
- Patient Flow Management
Background:
- High leave-without-being-seen (LWBS) rates in emergency departments (EDs) are a significant concern.
- While wait times are known to influence LWBS rates, specific targets for different patient acuity levels are not well-established.
Purpose of the Study:
- To analyze LWBS rates across different triage classes.
- To determine target wait times necessary to achieve specific LWBS rate reductions.
Main Methods:
- A 3-year retrospective analysis of 143,698 adult patients in an urban, tertiary, academic ED.
- Data were stratified by year, day, and hour to analyze mean actual wait times and abandonment proportions.
- Regression analysis using weighted least squares was performed to model abandonment based on wait times.
Main Results:
- Wait time was the primary driver of LWBS for Emergency Severity Index (ESI) 3 patients (R(2) = 0.88).
- To achieve an overall LWBS rate below 2%, target wait times should be under 10 minutes for ESI 2, under 45 minutes for ESI 3, and under 60 minutes for ESI 4/5 patients.
Conclusions:
- Understanding patient abandonment behavior is essential for setting effective LWBS targets.
- Operational redesign is necessary to meet target wait times and reduce LWBS rates in emergency departments.
