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Slide Presentation from the AHRQ 2007 Annual Conference

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ED Patient Safety Challenge

Text Description is below the image.
  • Capacity constrained EDs
    • Increased visits
    • Holding inpatients
  • Long waits for patients arriving
    • Patients deteriorating in the waiting room
    • Patient complaints, patient dissatisfaction
  • Patients leaving without treatment
    • self-diagnosis is not safe!
    • Long waits to see an ED physician related to LWOTs

Notes:

Issues with ED crowding are pretty well known (increasing visits, not enough ip beds, pts getting sicker as they wait, being unhappy) and patients leaving without being seen
Banner began to understand it not just as an "inconvenience" but as a 'patient safety' issue-the literature confirmed our conclusion.
"A study of the consequences of leaving the emergency department prior to a medical evaluation at one public hospital found that 46 percent of those who left were judged to need immediate medical attention, and 11 percent who left were hospitalized within the next week."[1]

"At follow-up, patients who left without being seen were twice as likely as those who were seen to report that their pain or the seriousness of their problem was worse."[2]

"Of the children who left without being seen, 24 (15%) were triaged as "urgent," and none had a CTAS score of less than 3...Our finding that 15% of patients who left without being seen had been triaged as "urgent" is of concern."[3]

"Forty-six percent of those who left were judged to need immediate medical attention, and 29% needed care within 24 to 48 hours."[4]

"Overall, 60% of LWBS (Left Without Being Seen) cases sought medical attention within one week; 14 patients were hospitalized, and one required urgent surgery."[5]

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