title: Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India.
abstract: BACKGROUND
  Emergency Department (ED) of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients.
  
  
  OBJECTIVE
  The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD).
  
  
  METHODS
  This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc.) of the emergency.
  
  
  RESULTS
  Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be 9.00-12.00 h in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients under observation (29.6%); waiting for routine diagnostic tests (16.4%) and waiting for discharge (14.6%). Around 71% patients were waiting due to reasons within emergency complex.
  
  
  CONCLUSIONS
  The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Tiwari
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sonu
authors.initials: S
authors.lastname: Goel
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Amarjeet
authors.initials: A
authors.lastname: Singh
keywords: Emergency department; inter arrival gap; overcrowding; patient flow; waiting time
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