Mat Aripin, Azzuani
(2014)
A study on the waiting time and processing time of green zone cases when triage by a doctor applied to edhusm.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: In many countries, hospital Emergency Departments (ED) are experiencing problem associated with increased demand for their services. As a result,
patient waiting times and overall processing time in the ED have increased beyond the acceptable level set by the government. In order to address the problems associated with this increased demand, numbers of projects were undertaken such as fast track approach, team triage, and mapping patient flow in ED. Thus, this study focused on
effect of triage by doctor on waiting time and overall processing time and factors influencing the outcome.
Objectives: Generally the objectives of this study were to determine the waiting time and processing time of green zone cases when triage by doctor applied to EDHUSM
and to determine factors influencing outcome. Specifically, to study mean difference in waiting time and processing time between patient with triage by doctor and triage
without doctor. Then, to study on factor influencing overall processing time and to
determine association between patient’s satisfaction with the outcome.
Methods: This prospective study was conducted in EDHUSM from 1st March 2013 to
30th April 2013, for only 6 hours a day. All green zone cases were included in this
study. Exclusion criteria were all fast track patients (NNJ, psychiatry, Bronchial
Asthma, OSCC), all yellow zone cases, and all red zone cases. Their time of registered,
time of triaged, time seen by doctor and time of referred or discharged or admitted were
monitored. Apart from that, every procedures including medications, radiograph, blood
sampling, ECG, POCT were stated and ticked in the study form. Waiting time means
the time they registered to the time they first seen by doctor with intervention.
Processing time means time of registered to the time of discharged or referred or
admitted. After overall processed, patient or their relatives were asked to fill up
satisfactory feedback form.
Results: There were total of 260 subjects (130 subjects each group) in this study.
Waiting time and processing time among patient who have been triaged by doctor was
significant with p<0.001 compared to patient triaged without doctor.No significant
difference between trauma and non-trauma patient in terms of waiting time when
triaged by doctors with p value = 0.238.The factors that influencing the processing
times in both groups were treatment without doctor, number of procedures and
weekdays (p<0.001). In multiple logistic regression analysis only three factors were
found to have significant association with poor satisfaction when triaged by a doctor
applied to EDHUSM. They were the duration of their illness (p = 0.004), prolonged
waiting time (p<0.001) and longer processing time (p<0.001).
Conclusion: We concluded that, triage by a doctor can shorten waiting time and
improved the processing time by quick assessment and intervention. Indirectly, it will
reduce overcrowding in emergency department. Hence, reduce complaints and
dissatisfaction.
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