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Review
. 2021 Oct;33(5):932-934.
doi: 10.1111/1742-6723.13820. Epub 2021 Jun 29.

Contemporary evaluation of adverse outcome risks associated with 'did not wait' emergency department presentations

Mohamed Eftal Bin Mohamed Ebrahim  1   2 , Matthew Tang  1 , Matthew Vukasovic  1 , Andrew Coggins  1   2
Affiliations
Review

Contemporary evaluation of adverse outcome risks associated with 'did not wait' emergency department presentations

Mohamed Eftal Bin Mohamed Ebrahim et al. Emerg Med Australas. 2021 Oct.

Abstract

Objective: Did not wait (DNW) is a frequently cited ED key performance indicator. We conducted a network-based observational study of consecutive DNW presentations.

Methods: Prospective cohort study of Western Sydney Local Health District with a primary outcome measure of reported 30-day all-cause mortality and secondary outcomes of demographic characteristics and representation risk. For re-presenting patients who were subsequently admitted, a manual review of electronic records and incident report systems based on a priori plan assessed each case for the length of stay and adverse outcomes.

Results: During the study window, there were 1114 DNW presentations with 172 (15.4%) re-presentation within 72 h. The analysis of re-presented patients did not reveal adverse outcomes or prolonged length of stay. A review of available outcomes data revealed one DNW patient died within 30 days but had a previous palliative plan for terminal illness.

Conclusion: While a proportion of DNW patients re-presented within 72 h, an excess prevalence of poor outcomes were not observed.

Keywords: did not wait; emergency department; key performance indicator; patient safety; quality improvement.

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References

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    1. O'Keeffe F, Cronin S, Gilligan P et al. Did not wait patient management strategy (DNW PMS) study. Emerg. Med. J. 2012; 29: 550-3.
    1. Melton N, Mitchell M, Crilly J, Cooke M. Patient characteristics and institutional factors associated with those who “did not wait” at a South East Queensland Emergency Department: who are those who “did not wait” in ED? Australas. Emerg. Nurs. J. 2014; 17: 11-8.
    1. Gilligan P, Joseph D, Winder S et al. DNW-“did not wait” or “demographic needing work”: a study of the profile of patients who did not wait to be seen in an Irish emergency department. Emerg. Med. J. 2009; 26: 780-2.
    1. Ebker-White AA, Bein KJ, Dinh MM. The Sydney Triage to Admission Risk Tool (START): a prospective validation study. Emerg. Med. Australas. 2018; 30: 511-6.

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