Waiting times in a paediatric emergency department

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.