Are wait times and length of stay in Alberta emergency departments for children’s mental health meeting national benchmarks? Trends from 2002 to 2008

Abstract

To describe wait times, treatment times and length of stay (LOS) for pediatric mental health visits to emergency departments (EDs). The present study was a retrospective cohort analysis of mental health visits (n=30,656) made by children <18 years of age between April 2002 and March 2008 to EDs in Alberta using administrative data. Wait time (time from triage to physician assessment), treatment time (time from physician assessment to end of visit) and LOS (time from start to end of visit) were examined for each visit. Wait time and treatment time data were available for 2006 to 2008, and LOS data were available for all study years. Wait times and LOS were compared with national benchmarks for the Canadian Triage and Acuity Scale (CTAS; levels 1 [resuscitative] through 5 [nonurgent]). All times are presented in h and min. Median wait times for visits triaged as CTAS 1, 2, 3 and 4 exceeded national recommendations. The longest wait times were for visits triaged as urgent (CTAS 3; 1 h 46 min) and less urgent (CTAS 4; 1 h 45 min). Lower-acuity visits had wait times that exceeded treatment times (CTAS 4: 1 h 45 min versus 1 h 8 min; CTAS 5: 1 h 5 min versus 52 min). Across all CTAS levels, the LOS in the ED increased during the study period, but met national benchmarks. Most median ED wait times for pediatric mental health visits exceeded national recommendations, while the median LOS for all visits met recommendations. Lower-acuity visits had wait times that exceeded treatment times. Future research should explore whether longer wait times are associated with adverse outcomes, and whether current wait/treatment times are warranted to ensure that ED throughput is optimized.