Mohammad A Tashkandy, Zohair Jamil Gazzaz, Mian Usman Farooq, Khalid O Dhafar.
Reasons for delay in in-patient admission at an Emergency department.
J Ayub Med Coll Abottabad Jan ;20(1):38-42.

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.

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