title: Difference in time to x ray with similar time to treatment decision leads to differences in waiting times of patients with hip fracture in a crowded emergency department.
abstract: OBJECTIVE
  Crowding of patients is common in emergency departments. The number of hip fracture patients not regarded as urgent builds up and patients wait for treatment. In this paper, we present the causes of waiting time and provide some suggestions to improve patient flow in emergency departments.
  
  
  METHODS
  We undertook a retrospective review of emergency department records. Included in this study were 112 hip fracture patients seen between January 2005 and January 2007 at an urban, academically affiliated trauma centre. We recorded time to admission, to x ray, and to a definitive treatment decision. Patients were divided into two groups based on time to x ray of < or = 5 min, or > 5 min.
  
  
  RESULTS
  There was no difference in the time between taking the x ray and the definitive decision on treatment in the two groups.
  
  
  CONCLUSIONS
  We may reduce total waiting time for hip fracture patients by taking an x ray during triage. There are many patients in crowded emergency departments whose symptoms of hip contusion and hip pain, and with a clear history of a fall, are known at admission. Taking an x ray during triage when a patient presents with a typical history and symptoms can reduce total waiting time. We hope that further evaluation could confirm this point.
authors.affiliation: Department of Emergency Medicine, Hsin Chu General Hospital, Department of Health, Executive Yuan, ROC, No25, Lane 442, Sec. 1, Jingguo Road, Hsinchu City 300, Taiwan, ROC. 4926602@yahoo.com.tw
authors.forename: W-T
authors.initials: WT
authors.lastname: Chia
authors.forename: Y-S
authors.initials: YS
authors.lastname: Chen
authors.forename: C-F J
authors.initials: CF
authors.lastname: Lin
authors.forename: H-H
authors.initials: HH
authors.lastname: Liu
authors.forename: B-F
authors.initials: BF
authors.lastname: Lin
mesh_terms: D003441:Crowding; D003657:Decision Making; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D011859:Radiography; D012189:Retrospective Studies; D013624:Taiwan; D013997:Time Factors; D014193:Trauma Centers; D014218:Triage; D014850:Waiting Lists