Long waiting times linked to increased risk of injury
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This study suggests that if a patient attends at A&E, the longer they wait for treatment the more likely they are to have a condition missed, and to be allowed to go home, where thated condition escalates leading to re-admission.
Alternatively the increased time spent waiting for treatment may lead to delays in providing essential treatment without which the condition escalates leading to admission.
In the UK, until November 2010, emergency departments had to complete a patient's treatment within 4 hours. Since changes introduced removing the 4 hour target, replacing the four hour target with a series of eight clinical indicators, Department of Health statistics show an increase in waiting times.
Between October and December 2010, 3.52 per cent of the 5.24 million treated in A&E waited more than four hours to be discharged, admitted to hospital or transferred to another department. This is an increase from the previous year, where only 2.16 per cent of the 5.13 million people treated in A&E waited more than four hours (as reported by the Daily Telegraph on 3 February 2011).
What is not clear is what particular factors lead to the increased risk for the patient. Based on our experience of running cases for claimants who have suffered an avoidable injury after attending at an Emergency Department, I would surmise that delays in starting necessary treatment allows the condition needing treatment to get much worse leading to the need for hospital admissions.
Whilst a simple 4 hour rule was a rather blunt tool, and the changes to introduce a more refined and patient focussed way of assessing patient needs was a reasonable change, the results of this Canadian study do strike a note of caution - if waiting times creep up in the emergency department it is likely we will see an increase in patients suffering harm as result in the delay in treatment being started.
Further reading on this subject can be seen here.
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