title: Did not wait patient management strategy (DNW PMS) study.
abstract: OBJECTIVE
  This study was undertaken to assess the usefulness of senior emergency medicine specialists' review of all 'did not wait' (DNW) patients' triage notes and the recall of at-risk patients. METHODS; A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution.
  
  
  RESULTS
  2872 (6.3%) of 45,959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall.
  
  
  CONCLUSIONS
  The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.
authors.affiliation: Emergency Department, Beaumont Hospital, Beaumont Road, Dublin, Ireland. fokeeffe@gmail.com
authors.forename: Fran
authors.initials: F
authors.lastname: O'Keeffe
authors.forename: Sinead
authors.initials: S
authors.lastname: Cronin
authors.forename: Peadar
authors.initials: P
authors.lastname: Gilligan
authors.forename: Patrick
authors.initials: P
authors.lastname: O'Kelly
authors.forename: Aidan
authors.initials: A
authors.lastname: Gleeson
authors.forename: Patricia
authors.initials: P
authors.lastname: Houlihan
authors.forename: Sherif
authors.initials: S
authors.lastname: Kelada
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D017063:Outcome Assessment, Health Care; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data*; D014218:Triage / Q000706:statistics & numerical data*