Those who opt to leave: Comparison by triage acuity of emergency patients who leave prior to seeing a medical practitioner.

BACKGROUND

People who present to an emergency department but leave before seeing a medical practitioner (LWBS) pose a potential risk, especially those triaged with higher acuity care needs.

OBJECTIVE

To describe and compare characteristics of emergency patients who LWBS by triage acuity.

METHOD

Retrospective review of administrative data for a 1-year period. Chi-square and logistic regression analyses conducted to investigate differences in characteristics specific to individual and the timing of presentation between patients who LWBS and were triaged as higher acuity compared to those who left but were triaged as less- or non-urgent.

RESULTS

During study period, 12.6 % of patients LWBS with 30.0 % of these cases triaged as higher acuity. Number triaged as higher acuity who LWBS tended to be higher during days with a higher volume of higher acuity cases. The likelihood of LWBS for those triaged as higher acuity was higher among older age groups and those with a primary care provider who presented on weekdays, during evening and night shifts, and in the winter months.

CONCLUSIONS

Findings highlight differences in LWBS cases by triage acuity and raise questions about emergency nurses' professional responsibility to follow-up with those who LWBS if they have been triaged as higher acuity based on an assessment of their presenting complaint and risk for complications or deterioration. While continuing to work to reduce wait times and improve patient flow, it is important to identify factors affecting patients' decision to LWBS, especially for those triaged with higher acuity healthcare needs.