The lenght of stay in the Pediatric Emergency Department

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Giedrė Povilaitytė1, Viktorija Mejerytė1, Rūta Čeidaitė1

1Faculty of Medicine, Academy of Medicine, Lithuanian University of Health Sciences

ABSTRACT

Introduction: Number of patients, presenting to the Emergency Department (ED), is constantly increasing. Overcrowded EDs are associated with longer waiting time, delayed diagnosis, treatment and patients and doctors dissatisfaction (1,3,5,6). In order to prevent this, triage systems to prioritize patients and to ensure that they are seen in order of clinical need in EDs is necessary (1).

Aim: to assess the length of stay (LOS) in the Pediatric Emergency Department (PED) and determine the longest processes during visits.

Methods: this was a prospective study of children aged ≤ 18 years who were admitted to the PED of the Hospital of Lithuanian University of Health Sciences (HLUHS) Kauno Klinikos from 1st to 31st of July, 2018. Registration time of 40 children and total LOS of 50 patients was assessed. The PED nursing staff in this hospital uses the pediatric Triage Acuity Scale to divide patients into five categories according to their medical condition: level 1 – immediate evaluation and care, level 2 – evaluation and care within 15min, level 3 – 30 min, level 4 – 60 min, and level 5 – 120 min. Data were analyzed with SPSS 23.0. A p value of < 0.05 was considered significant.

Results: the median LOS in PED was 95.5 ± 85.81 min (10 – 525 min). Waiting for doctors examination was 16,58 ± 9,38 min (4 – 40 min). Almost all patients were examined within the limit according the initial triage category. There were 42 (84%) level 4 and 8 (16%) level 3 patients. There was no significant difference in LOS between these groups. Median registration time was 6.60 ± 5.57 min (2 – 37 min). Preparation of medical documentation during the registration process took the longest (median time – 2min).

Conclusions: the Triage Acuity Scale is implemented in HLUHS and patients in PED are evaluated according to Triage categories. This model works in this hospital properly. Median LOS was approximately 1.5 hours and the longest process was waiting for the lab results.

Keywords: Emergency Department, length of stay, child, waiting time.