Waiting time in an urban accident and emergency department--a way to improve it

To determine how the introduction of a new small team consultation system could reduce the average waiting time of patients in the busy accident and emergency (A&E) department of a Hong Kong hospital.

1,264 and 1,319 A&E cases, respectively, were samples during the four months before and after the introduction of a new small team consultation system. The data collected included the average and the range of the patients' waiting time as well as the number of patients in different triage categories and their average waiting time. Also recorded in the study were the average daily attendance, the admission rate, the number of complaints, and patients reattendance rate.

Before and after the introduction of the new system, the average waiting time of the patients was 35.19 minutes and 22.04 minutes respectively (range 0 to 134.0 minutes and 0 to 106.3 minutes, respectively). The difference of 13.15 minutes in the average waiting times was clinically and statistically significant (t = 2.81; P = 0.004). There were no significant changes in other variables affecting the patients' waiting time and the quality o service.

A small team consultation system can reduce the average waiting time of patients without compromising the existing quality of service.