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Your search keyword '"Chiu, P. T."' showing total 144 results
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144 results on '"Chiu, P. T."'

14. The association between day of arrival, time of arrival, daily volume and the rate of patients that "left without being seen".

Author

Chiu, David T., Stenson, Bryan A., Alghamdi, Mohammed, Antkowiak, Peter S., and Sanchez, Leon D.

Abstract

Patients' left without being seen (LWBS) rate is used as an emergency department (ED) quality indicator. Prior research has investigated characteristics of these patients, but there are minimal studies assessing the impact of departmental variables. We evaluate the LWBS rate at a granular level, looking at its relationship to day of week, hour of arrival and total patient volume. Retrospective cohort analysis of 109,983 cases from a single academic center. We captured patient disposition, day of week and hour of day of arrival, and total daily volume. Chi-squared test was performed to determine the difference in LWBS rates based on arrival variables. We ran a polynomial regression for LWBS rates by decile of daily patient volume. The overall LWBS rate was 1.82% over 2 years. This varied significantly by day of week and hour of day (p < 0.001). Day of week rates ranged from 0.73% on Sunday to 2.45% on Wednesday. Hour of day rates ranged from 0.26% between 8 AM–9 AM, to 3.71% between 10 PM–11 PM. As total daily patient volume increased, LWBS rates gradually increased until the 70th percentile, followed by significant exponential growth afterwards. LWBS rates are not static measurements, and vary greatly depending on ED circumstances. Weekdays and evenings have significantly higher rates. Additionally, LWBS rates climb above 2% as daily registrations reach the 70th percentile, increasing exponentially at each subsequent decile. Understanding these effects will allow for more effective, targeted interventions to minimize this rate and improve throughput. • LWBS rate is not static and varies greatly depending on departmental circumstances. • Hour of day and day of week contribute to the variability of the LWBS rate. • LWBS rates gradually increase from the 40th to 70th percentiles in volume. • Above the 70th percentile in daily volume, LWBS rates increase exponentially. • This variability must be accounted for when deploying strategies aimed at improving LWBS rates. [ABSTRACT FROM AUTHOR]

Published
2023
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21. Parental psychopathology and the risk of suicidal behavior in their offspring: results from the World Mental Health surveys

Author

Gureje, O, Oladeji, B, Hwang, I, Chiu, W T, Kessler, R C, Sampson, N A, Alonso, J, Andrade, L H, Beautrais, A, Borges, G, Bromet, E, Bruffaerts, R, de Girolamo, G, de Graaf, R, Gal, G, He, Y, Hu, C, Iwata, N, Karam, E G, Kovess-Masféty, V, Matschinger, H, Moldovan, M V, Posada-Villa, J, Sagar, R, Scocco, P, Seedat, S, Tomov, T, and Nock, M K

Published
2011
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42. Analysis of time-to-disposition intervals during early and late parts of an emergency department shift.

Author

Stenson, Bryan A., Antkowiak, Peter S., Balaji, Lakshman, Grossestreuer, Anne V., Joseph, Joshua W., Chiu, David T., and Sanchez, Leon D.

Abstract

Introduction: Time-to-disposition is an important metric for emergency department throughput. We hypothesized that providers view the shift end as a key timepoint and attempt to leave as few dispositions as possible to the oncoming team, thereby making quicker decisions later in the shift. This study evaluates disposition distribution relative to when patients are assigned a provider during the course of a shift.Methods: 50,802 cases were analyzed over the one-year study interval. 31,869 patients were seen in the early half of a shift (hours 1-4) and 18,933 were seen in the later half (hours 5+). We ran a linear mixed model that adjusted for age, gender, emergency severity index score, time of day, weekend arrivals, quarter of arrival and shift type.Results: Median time-to-disposition for the early group was 3.25 h (IQR 1.90-5.04), and 2.62 h (IQR 1.51-4.31) for the late group. From our mixed model, we conclude that in the later parts of the shift, providers take on average 15.1% less time to make a disposition decision than in the earlier parts of the shift.Conclusion: Patients seen during the latter half of a shift were more likely to have a shorter time-to-disposition than similar patients seen in the first half of a shift. This may be influenced by many factors, such as providers spending the early hours of a shift seeing new patients which generate new tasks and delay dispositions, and viewing the end of shift as a landmark with a goal to maximize dispositions prior to sign-out. [ABSTRACT FROM AUTHOR]

Published
2021
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