Objectives: The purpose of this study was to identify factors associated with urgent care patient length of stay.
Methods: In an urban, hospital based, emergency center all urgent care treatment data was reviewed for patients treated on twelve selected days (N=963). A random sample of 30 visits was then selected for each day, resulting in a final sample of 360 visits. Treatment and length of stay information for each visit, as well as aggregate data about the patients who registered in the hour prior to them, and emergency services staffing were included in the analysis.
Results: Stepwise discriminant function analysis identified six factors as predictors of longer patient stays: Whether the patient had a laboratory procedure (p<.001), whether they had an x-ray (p<.001), the number of patients triaged in the past hour (p<.001), the number of children (<6) treated in the past hour (p=.030), the number of patients treated in the past hour who had a laceration repair (p=.003), and the number of certified medical assistants (CMAs) working at the time of the visit (p=.035).
Conclusions: Length of stay increases if: 1) The patient requires ancillary services, such as laboratory or x-ray; 2) The number of patients requiring care increases, especially if any of them are children, who require more attention; or 3) The number of other patients requiring laceration repair increases. Staffing of not only urgent care, but also of ancillary service areas, needs to be reviewed to assure sufficient staffing with appropriately trained and skilled providers.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1) Identify 6 main factors that contribute to patient length of stay in a hospital-based urgent care clinic. 2) Identify health system medical staffing issues that contribute to patient length of stay. 3) Understand administrative decision making criteria necessary to effect long term change in patient length of stay and emergency services overcrowding
Keywords: Emergency Department/Room, Access to Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment:
Director of Emergency Services
St. Mary's/Duluth Clinic Health System (SMDC)
Duluth, Minnesota
(Data included in this study came from and was analyzed at SMDC.)