Reasons for delay in inpatient admission at an emergency department

This study highlighted the reasons which contributed to longer stay of patients in Emergency Department [ED] who were advised admission. 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 and 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. 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]. Out of admitted patients 67% were delayed mainly due to late advised admission with major reason of delay were multiple consultations