title: Analysis of a Patient Intervention to Reduce Patients Who Leave Without Being Seen in an Ophthalmology-Dedicated Emergency Room.
abstract: Patients who leave without being seen (LWBS) by a medical provider in emergency care settings are a concern because their urgent complaints remain unaddressed. This study aims to characterize the LWBS population in an ophthalmology-dedicated emergency room and to evaluate an intervention designed to decrease the number of these patients. A program of rounding and patient contact in the waiting room of our emergency room was initiated to this end. A patient database was used retrospectively to review 13,124 charts and collect clinical and demographic data on 71 LWBS patients. The percentage of LWBS patients decreased from 0.74% to 0.33% after the intervention (p = 0.00158). Of the LWBS patients, 27% were seen in an ophthalmology clinic within 2 weeks, and 4% were seen back in the emergency room. Of these patients, 49% had some ophthalmology follow-up after leaving. Among those with follow-up, 14% had concerning pathology. Of all LWBS patients, 63% had a primary care physician. We conclude that frequent rounding in an emergency room waiting room can decrease the number of LWBS patients and as such reduce morbidity. This strategy offers potential to improve healthcare outcomes in emergency settings.
authors.forename: Alice C
authors.initials: AC
authors.lastname: Lorch
authors.forename: Maureen
authors.initials: M
authors.lastname: Martinez
authors.forename: Matthew
authors.initials: M
authors.lastname: Gardiner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000592:standards* / Q000706:statistics & numerical data; D016079:Refusal to Treat / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States; D014850:Waiting Lists