A study on waiting time and length of stay of attendants to emergency department of Vali-e-Asr Hospital, Arak-Iran

Delivery of immediate medical interventions appropriate to the severity of clinical status of patients is a main public expectation of emergency departments. Waiting time and length of stay are the key measures to asses the quality of care in emergency departments. This study is done to investigate the waiting time and length of stay of attendants to emergency department of Vali-e-Asr Hospital, Arak-Iran. This analytical cross-sectional research was conducted in a general emergency department of a teaching hospital in Arak to asses the waiting time and length of stay of patients. In the first stage of the study all attendants during a 6 weeks period were classified regarding to the severity of their clinical status by an educated nurse and a general practitioner using a three category scale (guideline) presented by ministry of Health and Medical Education (2001). Also waiting time for a general practitioner visit was measured and documented by the resident general practitioner. In the second stage, a sample of 100 documents of patients in group 1 and 2 admitted for specialist visit were assessed for the waiting time and length of stay in emergency department. Mean of waiting time according to patients clinical status and the specialty of the first physician were analyzed by t-test and ANOVA (p =0.05). During a 6 weeks period, of 1963 patients, 179(9.1%) were categorized as emergent (category 1), 391(19.9%) urgent (category 2) and 1393 (71%) non urgent. The mean waiting time for general practitioner visit was 5 minutes. The median and mean of waiting time for specialist visit in group 1 and 2 of patients were 225 and 262±156, 220 and 227±153 minutes, respectively. The median and mean of length of stay was 1 and 2 days, respectively. No differences were found between waiting time of various specialties visit in patients of categories 1 and 2. Regarding the long waiting time for specialist visit, using triage in emergency departments is necessary. This needs planning and organization for the presence of specialists in the hospital, over the time. Also regarding the large number of nonurgent patients, 24 hours presence of a general practitioner is necessary.