Patients who leave the paediatric emergency department. A 240,000 visits analysis.

João Viana1, Mayara Nogueira2, Alberto Freitas3, Almeida Santos2


Introduction: The rate of patients who visit an emergency department(ED) and leave without being seen by a doctor is an important performance indicator. These patients could be at risk for bad outcomes since they leave without completing their treatment or without any medical advice.

Aim: To determine patterns in patients LBWS, analysing demographic and clinical presentation from the patients and from the flow process in the ED. We also intend to find out where they go after leaving the ED and if there is any unfavourable outcome.

Methods: The study was performed in the Paediatric Emergency Department(PED) of Hospital São João. Data was collected from a database, from 1st January 2014 to 31st December 2016. The visits were divided into 2 groups, the cases were de LWBS children and the controls were visits made by patients who completed the expected flow.

Results: The average LWBS rate for the 3 years was 2.6%, 6183 visits. Higher LWBS rates can be tied to specific time periods. When compared with visits that completed the PED flow, patients triaged as less urgent had higher LWBS rates. Occupancy correlates with LWBS (used as a proxy for waiting times). 20% of patients that LWBS and were triaged as Level2 (30 visits), seeked HC services within 5 days.

Discussion: This study elucidates the characteristics of patients that LWBS in order to plan targeted interventions to minimize their number, this is especially important in high risk children e.g.those who were assigned a high triage level and those in risk of later hospital admission.

keywords: paediatric; emergency department; left without being seen;quality indicators

Presentation: Patients who leave the paediatric emergency department. A 240,000 visits analysis.