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[Premature departure from pediatric emergency department: retrospective analysis and preventive strategies.]

Alex Merolla, Emanuele Castagno, Ilaria Bergese

    Assistenza Infermieristica E Ricerca : AIR
    |June 27, 2019
    PubMed

    Insights

    Many children leave the pediatric emergency department (ED) due to long waits and low urgency. Addressing overcrowding and improving triage are key to preventing premature departures.

    Area of Science:

    • Pediatric Emergency Medicine
    • Healthcare Management
    • Patient Flow Optimization

    Background:

    • Emergency Department (ED) overcrowding leads to prolonged waiting times for pediatric patients.
    • Increased wait times contribute to patient and family dissatisfaction, prompting premature departures.
    • Understanding reasons for leaving before evaluation is crucial for improving care delivery.

    Purpose of the Study:

    • To characterize children who depart from a pediatric ED prior to medical examination.
    • To identify factors associated with premature departure from pediatric emergency care.
    • To inform strategies for reducing patient attrition in pediatric EDs.

    Main Methods:

    • Retrospective descriptive analysis of pediatric ED departures.
    • Data collected from June to November 2018 at a tertiary children's hospital.
    • Inclusion criteria: children leaving before medical evaluation.

    Main Results:

    • 1351 children (6.7% of visits) left prematurely.
    • Highest departure rates observed in November, evening shifts, and among 1-10 year olds.
    • Average wait time for departing patients was 131 minutes; common reasons for visit were fever and gastrointestinal issues.

    Conclusions:

    • Low urgency, extended waiting times, peak influx periods, and age (1-10 years) are significant factors for premature ED departure.
    • Further research is needed to assess the role of triage nursing effectiveness in early departures.
    • Strategies to mitigate overcrowding and reduce wait times are essential for pediatric EDs.

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