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"How long until I am seen, doc?" Modelling paediatric emergency department waiting times to make personalised
Sarah Rahayu Hogben1, Robin Marlow2,3
1Faculty of Health Sciences, University of Bristol, Bristol, UK sarahhogben@live.co.uk.
Insights
Predicting paediatric emergency department wait times using a tailored model can improve patient satisfaction. This study developed a model to provide personalised wait time predictions for children, successfully predicting wait times for over 84% of cases.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Predictive Analytics in Healthcare
Background:
- Emergency department (ED) wait times are increasing, leading to patient dissatisfaction.
- Managing patient expectations regarding wait times may be more effective than reducing actual wait times.
- Existing wait time prediction models are not specific to pediatric departments.
Purpose of the Study:
- To develop a predictive model for personalised wait times in a pediatric emergency department (ED).
- To assess the model's accuracy in predicting individual child wait times after triage.
Main Methods:
- A retrospective study of 40,828 pediatric ED attendances from January 2022 to December 2022.
- A multiple linear regression model was developed using 80% of anonymised administrative data for training and 20% for validation.
- Model success was defined as actual wait time within 30 minutes of predicted wait time.
Main Results:
- The median patient wait time was 65 minutes (IQR 34-122).
- The developed model successfully predicted wait times for 84.2% of attendances (95% CI 83.42% to 84.91%).
- Key predictors included triage category, patient volume, time of presentation, and day of the week (all p<0.001).
Conclusions:
- Individualised wait time prediction models for pediatric EDs can be created using routine data.
- These tailored predictions can help manage patient expectations.
- Improved expectation management has the potential to enhance patient satisfaction in pediatric ED settings.
Background:
ED patient wait times have been progressively increasing leading to patient dissatisfaction in ED. Managing patient expectations towards wait times in ED may be more effective at decreasing dissatisfaction than shortening actual wait times. Models for predicting wait times have been made for general EDs but not for solely paediatric departments. We aimed to create a model that could predict the personalised wait time of a child presenting to paediatric ED after triage.
Methods:
This was a single-centre retrospective study analysing all ED attendances to the Bristol Royal Hospital for Children between 1 January 2022 and 31 December 2022. From anonymised routinely collected administrative data, we created a multiple linear regression model to predict wait times. We developed the model by randomly assigning 80% of the data to a training set and used the remaining 20% as a validation set to assess the accuracy of our model. CIs were calculated using 500 bootstrap iterations sampled from the validation set. Understanding that patients are satisfied being seen sooner than their predicted wait time, we considered the result to be unsuccessful if their actual wait time was 30 min over their predicted wait time.
Results:
From 40 828 ED presentations, the median patient wait time was 65 min (IQR 34-122). Our model was able to predict wait times for 84.2% (95% CI 83.42% to 84.91%) of attendances successfully. Triage category, number of patients waiting, number of patients in the department, time of presentation, length of wait of last patient and day of week all had a significant impact on prediction of wait times (all p<0.001).
Conclusion:
Tailored models created using routine data can be used to give individualised predictions for wait times in paediatric ED, which could be given to patients with the aim of managing expectations and improving patient satisfaction.
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