Evaluation of the Patients’ Queue Status at Emergency Department of Nemazee Hospital and How to Decrease It, 2014

BACKGROUND: Patients, who seek care in emergency department, are waiting in queue and the health care provision in the department seems to be too overcrowded; the extended waiting time increases dissatisfaction and delays admission of new patients. In most of the hospitals considered to be overcrowded, the discharge rate of patients is managed by the use of “theory of queues”. This study was done to observe waiting time of patients in emergency department by “queue theory analysis” and computer simulator in an Iranian hospital.METHODS: This is a cross-sectional study in which simulation software (Arena, version 14) was used to build the 8 models. They run in a period of one month. The input information for the models was extracted from the hospital database and through sampling. The objective of this study was to evaluate the response variables of “waiting time” and “number waiting” of each level. RESULT: In level 2A, with increased number of beds with 20 beds, the waiting time decreased to 0.45 minutes and the percentage of deaths declined to 26.2%, but the number of discharge from this level declined, too. In level 3 with increased number of beds 2 times, waiting time decreased to 74 minutes and the percentage of death declined to 3.7% but the number of discharge from this level to ICU declined, too. CONCLUSION: This study showed the magnitude of ED overcrowding in Nemazee hospital. Increasing the bed capacity in the ED could reduce the waiting time in each part of ED.

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Discharge against medical advice from the emergency department in a university hospital

BMC Emergency Medicine ◽

10.1186/s12873-021-00422-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Feras H. Abuzeyad ◽

Moonis Farooq ◽

Salah Farhat Alam ◽

Mudhaffar Ismael Ibrahim ◽

Luma Bashmi ◽

...

Keyword(s):

Emergency Department ◽

Cross Sectional Study ◽

Small Sample ◽

Medical Advice ◽

University Hospital ◽

High Risk Population ◽

Cross Sectional ◽

Against Medical Advice ◽

Level 3 ◽

Collection Form

Abstract Background Patients discharged against medical advice (DAMA) act as a high-risk population for the Emergency Department (ED), regardless of their presentations, and can pose a serious burden for the hospital. This study examines the prevalence, demographic and clinical characteristics, reasons, and clinical outcomes of a small sample of DAMA patients in a teaching university hospital, including readmission, morbidity, and mortality. Methods A prospective, descriptive cross-sectional study was conducted in the ED of King Hamad University Hospital (KHUH) with 98,992 patient visits during a 1-year period from June 2018 to June 2019. Consenting DAMA patients were asked to complete a data collection form. Results Patients (n = 413) had a mean age of 44.1 years with a female majority (57.1%). The majority were categorized as triage level-3 (87.7%). The main reasons for DAMA included refusal of the procedure/operation (23.2%), long ED waiting time (22.2%), subjective improvement with treatment (17.7%), and children at home (14.8%), whereas the least selected reason was dissatisfaction with medical care (1.2%). Follow-up of DAMA patients revealed that 86 cases (20.8%) were readmitted to the ED within 72 h of which 41 (47.7%) cases were morbidity and 2 (2.3%) were mortality. Marital status was a predictor of DAMA patients who revisit the ED within 72 h. Conclusion The results act as a pilot study to examine a small sample of DAMA patients’ characteristics, diagnosis, and ED revisits. Hospitals should investigate further the DAMA population on a larger scale, reasons for refusing procedures, and utilize this knowledge to improve the healthcare process.

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UTILIZATION OF EMERGENCY DEPARTMENT, UKM MEDICAL CENTRE: PATTERN OF PATIENT

Jurnal Teknologi ◽

10.11113/jt.v78.8297 ◽

2016 ◽

Vol 78 (4-4) ◽

Author(s):

Wan Malissa Wan Mohd Aminuddin ◽

Wan Rosmanira Ismail ◽

Husyairi Harunarashid ◽

Raymond Azman Ali ◽

Ismail Mohd Saiboon ◽

...

Keyword(s):

Emergency Department ◽

Census Data ◽

Early Morning ◽

Cross Sectional Study ◽

Huge Number ◽

Cross Sectional ◽

Number Of Patients ◽

Ed Overcrowding ◽

Critical Patients

An emergency department (ED) is a front door for a hospital where a huge number of patients visit the department to seek immediate treatment. This has led to ED overcrowding. A cross sectional study was conducted to determine the pattern of patients attending the ED in a public teaching hospital in Malaysia. 2013 daily census data contained 66,603 patients were used. In this study, 62.1% of ED attendances are non-critical case. They commonly utilized the ED in the early morning, during weekends, and early part of the week. In conclusion, non-critical patients are seen to be the most frequent ED users. They are commonly present at the ED with minor problems. Hence, ED management should implement various solving methods in order to educate such people regarding the real functions of an ED.

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Management of the services of emergency department in a specialized hospital a cross sectional study

Update Dental College Journal ◽

10.3329/updcj.v6i1.29215 ◽

2016 ◽

Vol 6 (1) ◽

pp. 15-20

Author(s):

Reshma Ahmed ◽

Nihar Sultana ◽

Saieda Farzana ◽

Begum Sharifa Akhtar ◽

SM Ziauddin ◽

...

Keyword(s):

Emergency Department ◽

Waiting Time ◽

Emergency Treatment ◽

Service Management ◽

Standard Operating Procedure ◽

Cross Sectional Study ◽

Sectional Study ◽

Waiting Room ◽

Cross Sectional ◽

Emergency Drugs

Emergency department is one of the most important part of the hospital and also vulnerable to criticism. The reputation of a hospital rests to a large extent on the service of emergency department. A descriptive type of cross sectional study was conducted at Emergency Department (ED) of National Institute of Cardiovascular Diseases Hospital (NICVD), Dhaka to assess different aspects of the service management of ED which includes opinion regarding different services, reception facilities, overall management of ED, waiting time for the patients to be attended by a doctor, required time for completion of emergency treatment, suggestions of service receivers for further improvement of ED of the hospital. A total of 121 patients or patient attendance and 39 health personnel were interviewed by a structured questionnaire and a checklist was utilized for availability of equipments and drugs in ED. The collected data were processed and analyzed meticulously with the help of SPSS (Version 21) software on the basis of different variables. According to Standard Operating Procedure (SOP) all instruments were present, 15 emergency drugs had been listed, out of them Inj. Streptokinase, antiseptic liquid were not available at that time in the ED of the hospital. The study revealed that out of 160 respondents the mean age was 40.3 ± 5.81 years, opinion about different services provided in ED more than two third found satisfied, only 18.1 % service receivers mentioned about the waiting time at ED to be seen by a doctor was ?3 minutes, more than half (54.5 %) required 20-30 minutes for completion of emergency treatment, different suggestions were suggested for further improvement of ED like increase number of wheel chair, stretcher, ambulance, to supply required medicine from the hospital, separate ECG room for female patients, waiting room for patients attendance etc. However, specific problems identified by different stakeholders need to be critically appraised by the authority to improve the services further.Update Dent. Coll. j: 2016; 6 (1): 15-20

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The Buffering Effect of Humanity of Care in the Relationship between Patient Satisfaction and Waiting Time: A Cross-sectional Study in an Emergency Department

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17082939 ◽

2020 ◽

Vol 17 (8) ◽

pp. 2939

Author(s):

Sara Viotti ◽

Claudio Giovanni Cortese ◽

Jacopo Garlasco ◽

Erika Rainero ◽

Ifeoma Nneka Emelurumonye ◽

...

Keyword(s):

Emergency Department ◽

Patient Satisfaction ◽

Waiting Time ◽

Cross Sectional Study ◽

Self Report ◽

Cross Sectional ◽

Randomized Design ◽

Conditional Effect ◽

The Relationship

This study aims to examine whether humanity of care and environmental comfort played a role in moderating the relationship between waiting time and patient satisfaction in an emergency department (ED). The study used a cross-sectional and non-randomized design. A total of 260 ED patients in two hospitals in Italy completed a self-report questionnaire. Moderated regression showed that after adjusting for control variables, waiting time was significantly and inversely associated with patient satisfaction. Humanity of care and environmental comfort showed a positive and significant association with patient satisfaction. Finally, the interaction term between waiting time and humanity of care was found to be significant, whereas the interaction effect between waiting time and environmental comfort was not significant. The conditional effect showed that when humanity of care was low, waiting time was negatively and significantly related to patient satisfaction. By contrast, when humanity of care was medium and high, the relationship between waiting time and patient satisfaction was not significant. These findings shed light on the key role of humanity of care in moderating the relationship between waiting time and patient satisfaction. The complex interrelations emerged should be carefully considered when interventions to foster patient satisfaction in an ED context are planned.

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Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study

BMC Emergency Medicine ◽

10.1186/s12873-019-0260-3 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Paul Owono Etoundi ◽

Junette Arlette Metogo Mbengono ◽

Ferdinand Ndom Ntock ◽

Joel Noutakdie Tochie ◽

Dominique Christelle Anaba Ndom ◽

...

Keyword(s):

Emergency Department ◽

Pain Management ◽

Acute Pain ◽

Cross Sectional Study ◽

Sectional Study ◽

Acute Pain Management ◽

Cross Sectional ◽

Attitudes And Practices ◽

Knowledge Attitudes And Practices

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Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

European Journal of Pediatrics ◽

10.1007/s00431-021-04169-x ◽

2021 ◽

Author(s):

Giorgio Cozzi ◽

Marta Cognigni ◽

Riccardo Busatto ◽

Veronica Grigoletto ◽

Manuela Giangreco ◽

...

Keyword(s):

Emergency Department ◽

Pain Relief ◽

Local Anaesthesia ◽

Cross Sectional Study ◽

Emergency Setting ◽

Older Children ◽

Cross Sectional ◽

Paediatric Emergency Department ◽

Paediatric Emergency ◽

Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

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Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study

Journal of Clinical Medicine ◽

10.3390/jcm10112475 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2475

Author(s):

Olivier Peyrony ◽

Danaé Gamelon ◽

Romain Brune ◽

Anthony Chauvin ◽

Daniel Aiham Ghazali ◽

...

Keyword(s):

Emergency Department ◽

Logistic Regression ◽

Blood Cell ◽

Red Blood Cell ◽

Cross Sectional Study ◽

Red Blood Cell Transfusion ◽

Cross Sectional ◽

Acute Bleeding ◽

History Of ◽

Rbc Transfusion

Background: We aimed to describe red blood cell (RBC) transfusions in the emergency department (ED) with a particular focus on the hemoglobin (Hb) level thresholds that are used in this setting. Methods: This was a cross-sectional study of 12 EDs including all adult patients that received RBC transfusion in January and February 2018. Descriptive statistics were reported. Logistic regression was performed to assess variables that were independently associated with a pre-transfusion Hb level ≥ 8 g/dL. Results: During the study period, 529 patients received RBC transfusion. The median age was 74 (59–85) years. The patients had a history of cancer or hematological disease in 185 (35.2%) cases. Acute bleeding was observed in the ED for 242 (44.7%) patients, among which 145 (59.9%) were gastrointestinal. Anemia was chronic in 191 (40.2%) cases, mostly due to vitamin or iron deficiency or to malignancy with transfusion support. Pre-transfusion Hb level was 6.9 (6.0–7.8) g/dL. The transfusion motive was not notified in the medical chart in 206 (38.9%) cases. In the multivariable logistic regression, variables that were associated with a higher pre-transfusion Hb level (≥8 g/dL) were a history of coronary artery disease (OR: 2.09; 95% CI: 1.29–3.41), the presence of acute bleeding (OR: 2.44; 95% CI: 1.53–3.94), and older age (OR: 1.02/year; 95% CI: 1.01–1.04). Conclusion: RBC transfusion in the ED was an everyday concern and involved patients with heterogeneous medical situations and severity. Pre-transfusion Hb level was rather restrictive. Almost half of transfusions were provided because of acute bleeding which was associated with a higher Hb threshold.

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