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Waiting times in a paediatric emergency department
  1. J McInally,
  2. J Stirling
  1. Emergency Department, Royal Hospital for Sick Children, Glasgow, UK

Abstract

Aim (1) To assess patient wait times in the Paediatric Emergency Department (ED) and Medical Assessment Unit (MAU) of a tertiary paediatric hospital and compare them to those recommended by the Manchester Triage System.

(2) To compare wait times between the two areas.

Method A retrospective case note analysis of patients who attended the department in a one week period in September 2011.

Results

  • The majority of patients in triage categories 3, 4 and 5 are being seen within the recommended times. However, there are many patients within these categories who are waiting longer than recommended for medical review. No patients in triage category 1 appear to be reviewed within target time, similarly the bulk of triage category 2 patients seem to wait longer than recommended (figure 1).

  • There was a variety of wait times in triage categories 2-4. In particular, 45% of patients triaged as category 2 and went to MAU for review, who should be seen within 10 minutes of triage, waited more than half an hour to be seen, 17% waited more than an hour. No category 2 patient in ED waited more than half an hour (figure 2).

  • There was no significant difference in the mean time to review for triage category 2 patients between ED and MAU. Triage category 3 patients should be seen within 60 minutes. In ED they are seen in an average of 56 minutes, compared to 45 minutes in MAU. It took significantly longer for triage 4 patients to be seen in MAU (figure 3).

Conclusion

  • Waiting time targets are not met for many patients entering the department

  • Two main areas identified for improvement are timely review of category 2 patients allocated to the Medical Assessment Unit to be seen by a medical registrar and the triage category 3 patients allocated for review by ED doctor

  • We have identified that medical staff documentation could be improved to increase accuracy of monitoring

  • We will initiate changes designed to address the above and re-audit to monitor our progress.

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