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Contemporary evaluation of adverse outcome risks associated with 'did not wait' emergency department presentations
Mohamed Eftal Bin Mohamed Ebrahim1,2, Matthew Tang1, Matthew Vukasovic1
1Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.
Objective:
Did not wait (DNW) is a frequently cited ED key performance indicator. We conducted a network-based observational study of consecutive DNW presentations.
Methods:
Prospective cohort study of Western Sydney Local Health District with a primary outcome measure of reported 30-day all-cause mortality and secondary outcomes of demographic characteristics and representation risk. For re-presenting patients who were subsequently admitted, a manual review of electronic records and incident report systems based on a priori plan assessed each case for the length of stay and adverse outcomes.
Results:
During the study window, there were 1114 DNW presentations with 172 (15.4%) re-presentation within 72 h. The analysis of re-presented patients did not reveal adverse outcomes or prolonged length of stay. A review of available outcomes data revealed one DNW patient died within 30 days but had a previous palliative plan for terminal illness.
Conclusion:
While a proportion of DNW patients re-presented within 72 h, an excess prevalence of poor outcomes were not observed.
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