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Patient dissatisfaction in a paediatric accident and emergency department
R Hanson1, B Clifton-Smith, B Fasher
1Royal Alexandra Hospital for Children, Camperdown, NSW, Australia.
Insights
High Accident and Emergency (A&E) waiting times lead to patient walkouts, particularly during winter evenings. Addressing system failures is crucial for improving pediatric emergency care and patient satisfaction.
Area of Science:
- Pediatrics
- Emergency Medicine
- Healthcare Management
Background:
- Patient complaints and walkouts from pediatric emergency departments are critical issues impacting care delivery.
- Understanding reasons for patient departure is essential for service improvement.
Purpose of the Study:
- To review patient complaints and walkout reasons in a Children's Hospital Accident and Emergency (A&E) Department.
- To analyze the characteristics of patients who left without receiving care.
Main Methods:
- Retrospective review of patient records and complaints.
- Analysis of walkout rates, timing, and patient demographics.
- Categorization of presenting complaints and triage status.
Main Results:
- The walkout rate was 1.7%, with highest incidence during winter evenings (8 PM - 2 AM).
- Long waiting times were the primary reason for walkouts; most parents accepted advertised wait times.
- Presenting complaints varied, with most walkouts being non-urgent, but potential for significant morbidity existed.
- Patient outcomes were unknown for 53% of walkouts; written complaints focused on care quality.
Conclusions:
- System failures in the Accident and Emergency (A&E) department contribute to patient walkouts.
- Addressing waiting times and improving patient flow are necessary to reduce walkouts.
- Enhanced follow-up mechanisms are needed to understand patient outcomes after leaving without care.
Abstract:
This paper presents a review of the patient complaints and those who walked out prior to receiving care in the Accident and Emergency (A&E) Department of the Children's Hospital, Camperdown. The walkout rate was 1.7% (424/27,082) in 1992. Walkouts were greatest in winter when the department was busiest, peak period being between 2000 and 0200 hours. The waiting time was presented as the main reason for walking out. Most parents were prepared to wait the advertised waiting time before leaving. The presenting complaints of children who were not seen covered a spectrum of illnesses with the potential for significant morbidity. The majority, however, were triaged as non-urgent cases. Despite attempts to follow up on walkouts, the outcome for 53% of patients was unknown. Written complaints were fewer in number and tended to focus more on the quality of care (66.6%). There were few recorded compliments. With the increasing customer focus on health, greater attention needs to be given to system failures.
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