Menu
03/06/2011
Long Emergency Waiting Times Linked To Increased Risk
Long emergency department waiting times are associated with an increased risk of hospital admission or death within seven days among non-admitted patients, finds a study published on bmj.com.
The findings support policies to reduce the time patients wait and call into question government plans to abandon the 4-hour A&E target in England for lack of “clinical justification.”
Long emergency department waiting times are associated with delays in care and several countries have set targets for the time patients wait. Most (85%) of emergency department patients go home after their visit, but whether waiting times adversely affect their outcomes is unknown.
So researchers in Canada set out to determine whether patients who present to emergency departments during shifts with long waiting times are at risk for adverse events (hospitalisation or death within seven days).
Using data from high volume emergency departments in Ontario, Canada from 2003-2007, they identified 13,934,542 “seen and discharged” patients and 617,011 “left without being seen” patients.
Risk of short term adverse events increased with average emergency department length of stay.
Although the overall risk is low, risk of hospital admission increased by up to 95% while risk of death increased by up to 79% among the sickest patients.
Risk of death increased incrementally with each additional hour of average shift waiting time and the authors calculate that reducing emergency department length of stay by one hour, on average, could have potentially cut the number of deaths in this study in higher risk patients by 558 (6.5%) and in lower risk patients by 261 (12.7%).
Contrary to popular belief, patients who left without being seen were not at higher risk of short term adverse events compared with patients who were seen and discharged, nor were patients who attended emergency departments with high “left without being seen” rates.
This is reassuring, say the authors, as there has been much uncertainty surrounding outcomes of “left without being seen” patients. However, these results suggest that presenting to emergency departments during shifts with long average waiting times may have serious patient safety implications. They argue that there is likely clinical justification to reduce emergency department waiting times and they call into question recently announced plans to abandon English emergency department targets.
In an accompanying editorial, Melissa McCarthy, Associate Professor at George Washington University in the US writes: “We need to extend the evaluation of emergency care to either the resolution of the problem or transfer of care to a provider better suited to tackle the patient’s needs.”
She believes that emergency departments must be redesigned to meet patients’ needs more effectively and efficiently. Ongoing measurement of patient outcomes is also essential, she says, as is seamless integration between the emergency department and hospital and a stronger linkage to ambulatory care providers to enhance delivery of care and clinical effectiveness.
(BMcN/GK)
The findings support policies to reduce the time patients wait and call into question government plans to abandon the 4-hour A&E target in England for lack of “clinical justification.”
Long emergency department waiting times are associated with delays in care and several countries have set targets for the time patients wait. Most (85%) of emergency department patients go home after their visit, but whether waiting times adversely affect their outcomes is unknown.
So researchers in Canada set out to determine whether patients who present to emergency departments during shifts with long waiting times are at risk for adverse events (hospitalisation or death within seven days).
Using data from high volume emergency departments in Ontario, Canada from 2003-2007, they identified 13,934,542 “seen and discharged” patients and 617,011 “left without being seen” patients.
Risk of short term adverse events increased with average emergency department length of stay.
Although the overall risk is low, risk of hospital admission increased by up to 95% while risk of death increased by up to 79% among the sickest patients.
Risk of death increased incrementally with each additional hour of average shift waiting time and the authors calculate that reducing emergency department length of stay by one hour, on average, could have potentially cut the number of deaths in this study in higher risk patients by 558 (6.5%) and in lower risk patients by 261 (12.7%).
Contrary to popular belief, patients who left without being seen were not at higher risk of short term adverse events compared with patients who were seen and discharged, nor were patients who attended emergency departments with high “left without being seen” rates.
This is reassuring, say the authors, as there has been much uncertainty surrounding outcomes of “left without being seen” patients. However, these results suggest that presenting to emergency departments during shifts with long average waiting times may have serious patient safety implications. They argue that there is likely clinical justification to reduce emergency department waiting times and they call into question recently announced plans to abandon English emergency department targets.
In an accompanying editorial, Melissa McCarthy, Associate Professor at George Washington University in the US writes: “We need to extend the evaluation of emergency care to either the resolution of the problem or transfer of care to a provider better suited to tackle the patient’s needs.”
She believes that emergency departments must be redesigned to meet patients’ needs more effectively and efficiently. Ongoing measurement of patient outcomes is also essential, she says, as is seamless integration between the emergency department and hospital and a stronger linkage to ambulatory care providers to enhance delivery of care and clinical effectiveness.
(BMcN/GK)
Related UK National News Stories
Click here for the latest headlines.
22 September 2008
Scottish Government Pledges Cap On Surgery Waiting Times
Scottish patients may soon have a legal guarantee that they will wait no longer than 12 weeks for surgery. The Scottish Government's Patient Rights Bill proposes a strict limit on how long they have to wait from their surgical referral to receiving their operation.
Scottish Government Pledges Cap On Surgery Waiting Times
Scottish patients may soon have a legal guarantee that they will wait no longer than 12 weeks for surgery. The Scottish Government's Patient Rights Bill proposes a strict limit on how long they have to wait from their surgical referral to receiving their operation.
24 July 2007
Massive emergency operation underway following floods
A massive emergency operation is underway in order to provide clean water to 350,000 people in Gloucestershire who have been stranded without running water since Sunday.
Massive emergency operation underway following floods
A massive emergency operation is underway in order to provide clean water to 350,000 people in Gloucestershire who have been stranded without running water since Sunday.
21 February 2005
A&E waits shorter, but wards dirtier, say patients
Patients are experiencing shorter waits for emergency treatment and outpatient appointments, but believe hospitals are dirtier, the Healthcare Commission has found. Two major patient surveys of 140,000 patients, conducted by the Commission, also found that patients want more information regarding their treatment.
A&E waits shorter, but wards dirtier, say patients
Patients are experiencing shorter waits for emergency treatment and outpatient appointments, but believe hospitals are dirtier, the Healthcare Commission has found. Two major patient surveys of 140,000 patients, conducted by the Commission, also found that patients want more information regarding their treatment.
30 August 2011
A&E Waiting Times 'Over Two Hours'
A report from the NHS has revealed the average waiting times for those attending A&E is over two hours, writes Damien Whinnery in a 4NI.co.uk exclusive.
A&E Waiting Times 'Over Two Hours'
A report from the NHS has revealed the average waiting times for those attending A&E is over two hours, writes Damien Whinnery in a 4NI.co.uk exclusive.
10 November 2015
Search For Car In River Kent Continues
Emergency services are continuing to search the River Kent, after a car reportedly entered the water on Monday afternoon. It is understood that a vehicle has been sighted in the river but water levels are still high.
Search For Car In River Kent Continues
Emergency services are continuing to search the River Kent, after a car reportedly entered the water on Monday afternoon. It is understood that a vehicle has been sighted in the river but water levels are still high.
-
Northern Ireland WeatherToday:A showery start with outbreaks most frequent north of Lough Neagh and through the morning, before dwindling during the afternoon as the northwest breezes ease and brighter spells of weak sunshine prosper. Maximum temperature 8 °C.Tonight:A dry night, save for a few light showers around the coasts, with prolonged clear spells and light winds bringing a frosty dawn for many in central and southern parts. Minimum temperature -3 °C.
