Children who leave the emergency department without being seen: a retrospective case note review

Emerg Med J. 2015 Sep;32(9):712-5. doi: 10.1136/emermed-2014-204025. Epub 2014 Dec 2.

Abstract

Introduction: Children who attend an emergency department and then leave without being seen (LWBS) are a major concern as they are a potentially vulnerable group who may come to harm through failure to provide a timely and accessible service.

Objectives: We wished to establish the size of this population and importantly what subsequently happened to them over the following 7 days from their initial attendance, and the relevance of the College of Emergency Medicine LWBS Quality Indicator (QI 4) to this group.

Methods: A retrospective case note review over 6 months of all paediatric attendances who LWBS.

Setting: Southampton Paediatric Emergency Department.

Results: During a 6-month study period, 10 795 attended, of which 544 (5%) LWBS. 12.6% (69/544) reattended over the next 7 days, of which 14 were admitted, 7 for <12 h.

Conclusions: The majority who LWBS do so during peak times. Very few paediatric patients who LWBS then reattended required admission for >12 h (7/544, 1.3%). The rate of reattendance of those who LWBS and review of their case notes is potentially more valuable than the LWBS rate alone.

Keywords: emergency department; paediatrics.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Emergency Service, Hospital*
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Outcome Assessment, Health Care
  • Patient Acceptance of Health Care*
  • Retrospective Studies
  • Time Factors
  • Triage
  • Waiting Lists