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Authors: Rafael Kneuts , Inge Roggen , Ives Hubloue

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Abstract

Background: Patients leaving the emergency department (ED) without being seen (LWBS) by a physician are a worldwide known phenomenon. These patients represent 0.36 to 15% of the total number of patients visiting the ED, depending on the region and the settings of the ED. In this study we identified the prevalence and possible causes of this phenomenon in a large tertiary ED, with approximately 75000 yearly visits. Methods: Between 01 June 2018 and 30 November 2018, patients who had left the ED prematurely were contacted by phone, one week after their ED visit. A standardized questionnaire was used to conduct the phone survey. Additional information was acquired from the patient’s medical record. Results: A total of 598 out of 30127 patients (1.98%) left the ED prematurely, of which 509 (85.1%) were contacted by phone and 259 (43.4%) agreed to participate. LWBS patients were significantly younger, and the degree of emergency was significantly lower compared to the general population. The top 3 of the main reasons why people left the ED prematurely were the waiting time (74.9%), 13.1% suddenly felt better and 13.1% needed to be elsewhere. Of the LWBS patients, 40.1% were admitted between 6 pm and midnight, while only 31.7% of total ED visits took place during that timeframe. Conclusion: In our ED, patients who LWBS are young adults with less severe diseases. The waiting times are the main reason why patients are leaving the ED prematurely. Strategies to reduce waiting times or to inform these patients about waiting times could be implemented to reduce LWBS.

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Keywords: left without being seen, Emergency Department, quality assessment, quality improvement

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