Wednesday, July 24, 2013

Why Patients Stop Waiting

"Left without being seen" rates are tracked by every medical director – with fluctuations in this rate frequently resulting in knee-jerk interventions.  However, it's not necessarily well-understood which patients are actually at risk for LWBS, and why they leave.

This is a Wharton professor who took an operations modeling look at ED LWBS rates, stratified by Emergency Severity Index.  Using timestamp data from 150,000 ED visits, this approach derived four reasonable conclusions:
  • For patients with moderate severity, observing additional patients in the queue lead to increased abandoment.
  • Additional arrivals into the waiting room increased abandonment, while departures decreased abandonment.
  • Watching an arrival "queue-jump" due to higher acuity level increased chance of abandonment.
  • Initiation of diagnostic testing – such as triage protocols – reduced abandonment even if overall wait time was unchanged.
Overall, it's fascinating to see an somewhat agnostic perspective on the influences on waiting room patients.  The entire report is available as PDF directly from Wharton.

"Waiting Patiently: An Empirical Study of Queue Abandonment in an Emergency Department"
http://knowledge.wharton.upenn.edu/papers/download/06182013_Terwiesch-paper.pdf

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