Do Non-emergency Patients Make Other People Wait?

It is a common perception that patients with minor complaints are clogging the waiting rooms of emergency departments across the country. As patients sit closely together in the waiting room, the tension is palpable. The nurses at the triage desk hearing all kinds of complaints…..

“This wouldn’t take so long if there weren’t so many kids with stuffy noses.”

“How come the guy with the heart attack gets to go ahead of me? My cut is BLEEDING!”

“How serious can that ambulance be? I heard it’s just a Tylenol overdose. Tylenol can’t hurt you.”

You get the drift. Even some very well informed emergency physicians believe that if the less urgent patients were gone, emergency department crowding would stop. Dr. Michael Schull, et al, in a study published in this month’s Annals of Emergency Medicine, begs to differ. The authors studied 4.1 million patient visits to 110 emergency departments over a year. They found that only 12.4% of all patients were considered “low complexity” by their criteria. To be considered “low complexity” the patient had to have received a (4) less urgent or (5) non-urgent on the Canadian Triage Scale, had to have arrived by any method other than ambulance, and had to have been discharged.

The authors determined that the arrival of 10 low complexity patients over an 8 hour period increased the average time a patient stayed in the emergency department by 5.4 minutes. The average length of time until the patient saw a doctor was increased by 2.1 minutes. Results were the same regardless of teaching status of the hospital or emergency department annual volume.

It is human nature for people to search for a reason to complain when they have to wait. (Just try NOT counting the items of the people in front of you in the express lane.) Perhaps we should share the triage rank with the patient. It would be a little like the rides at Disneyland. Some people get a pass to go to the front of the line; others have to wait their turn…………….