Reasons for delay in inpatient admission at an emergency department.

OBJECTIVE This study highlighted the reasons which contributed to longer stay of patients in Emergency Department (ED) who were advised admission. METHODOLOGY This study was conducted from August 4 to 11, 2004G as a retrospective review of the ED cards of patients admitted to inpatients wards of Al-Noor Specialist Hospital, Makkah, Saudi Arabia. The demographic data, doctors & nurses notes with their timings were reviewed. The maximum consumed time by a reason was considered as the main reason of delay for that subject. The delayed patients were divided into Group A and B, delayed before and after admission was advised, respectively. Prolonged length of stay (Delay) in ED was defined as stay longer than 2 hours after patient's arrival in ED until they were received to wards. RESULTS Out of total 4876 visits during study period, 355 (7.3%) patients were admitted, and 238 (67%) were delayed. Age group 13-30 years was common in delayed 78 (32.8%) and not delayed 56 (47.9%) subjects. The mean length of stay of delayed subjects was 256 minutes. Group A 146 (61.4%) had more subjects than group B 92 (38.6%) (p < 0.001). Fifty eight (39.7%) patients stayed between 2-3hours in Group A vs. B 23 (25%) (OR 2, 95% CI 1.1-3.5). Common reason of delay in Group A was multiple consultations with further investigations 70 (48%) (p < 0.001) while file making process was common 40 (43.5%) in group B (p < 0.001). CONCLUSIONS Out of admitted patients 67% were delayed mainly due to late advised admission with major reason of delay were multiple consultations.