Exploring delay points at the emergency department

Abstract

Background  The increasing time spent in the emergency department is becoming a global problem contributing to overcrowding. The increased length of stay in the emergency department can negatively affect patients' perception of care, contributes to high morbidity and mortality rates, and increased aggression towards staff. Therefore, understanding the delay points will help administrators and policy makers channel resources to the areas that require improvement. Methods This is a cross-sectional descriptive study to evaluate the delay points in the emergency department. The study was conducted at level IV community hospital in British Columbia. One hundred sixty-seven participants were recruited using a consecutive convenience sampling. Results The total sample size of this study was 167 and the age of the respondents ranged from 18-101 years. There were more females (50.9%) than males (47.9%) or queer individuals. The care point with the longest wait time was tests to physician reassessment (median time 65 minutes), followed by physician to Imaging (median time 52 minutes) and finally nurse to physician assessment (median time 45 minutes). Despite the prolonged length of stay in emergency department, most participants enjoyed the courtesy of staff (74.7%, good-very good) and 59.9% indicated that they would recommend this emergency department to others. Conclusion Tests and waiting for physician reassessments are important points in the patient journey in the emergency department that can prolong length of stay. Future studies are needed to determine whether various interventions such as point of care testing, utilizing the Lean Model and improving physician services can help reduce lengths of stay in the emergency department.