Evaluation of Patient Flow and Waiting Time for the First Physician Visit in an Overcrowded Emergency Department

H. Yousefi, Fariba Asadi Noghabi, Samere Farhani Nejad, Mohsen yousefi
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Abstract

Background: The velocity of providing services in health centers is crucial to reduce mortality and adverse outcomes. Objectives: The present study aimed at determining the waiting time from entering the emergency department (ED) up to physician visiting based on congestion in the triple shift at Shahid Mohammadi Hospital in Bandar Abbas, Iran. Methods: The current cross-sectional, analytical study was conducted in 2019 on 1285 subjects selected from three shifts. The data collection tools included demographic data and standard triage forms, as well as a timetable with a stopwatch. The time between patient arrival and physician visit was recorded. SPSS software version 21 was employed to analyze the data. Results: The highest percentage of patients, 65.1% (n = 837), was non-traumatic, 38.98% (n = 501) referred during the evening shift, and 47.54% (n = 611) were related to the triage level 3. The maximum average waiting time from the beginning to the end of the triage was 4.46, and up to the physician, the visit was 12.8 minutes. Waiting time from entering ED up to physician first visit in terms of gender, refer to ED, and cause of referral statistically divulged a significant difference (P < 0.05). Estimation of the maximum congestion in the department was from 16:00 to 20:00, which showed a significant difference with other day times (P < 0.05). Conclusions: The average waiting time for patients was higher than the global standard. The interventions based on the maximum congestion in ED can be effective in reducing patient waiting time.
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在一个拥挤的急诊科,病人流量和第一次医生访问的等待时间的评估
背景:保健中心提供服务的速度对于降低死亡率和不良后果至关重要。目的:本研究旨在确定在伊朗阿巴斯港的Shahid Mohammadi医院,基于三班制的拥挤情况,从进入急诊科(ED)到医生就诊的等待时间。方法:目前的横断面分析研究是在2019年对三班制1285名受试者进行的。数据收集工具包括人口统计数据和标准分诊表,以及带秒表的时间表。记录患者到达和医生就诊之间的时间。采用SPSS软件21版对数据进行分析。结果:非创伤性患者占65.1% (n = 837),夜班患者占38.98% (n = 501),三级分诊患者占47.54% (n = 611)。从分诊开始到结束的最长平均等待时间为4.46分钟,到医生为止,访问时间为12.8分钟。从进入急诊科到医生首次就诊的等待时间,在性别、就诊情况、转诊原因方面差异有统计学意义(P < 0.05)。科室最大拥堵估计时间为16:00 ~ 20:00,与其他时段差异有统计学意义(P < 0.05)。结论:患者的平均等待时间高于国际标准。以急诊科最大拥挤程度为基础的干预措施可以有效减少患者的候诊时间。
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