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Research ArticleOriginal Article
Open Access

The effect of having a physician in the triage area on the rate of patients leaving without being seen

A quality improvement initiative at King Fahad Specialist hospital

Faisal T. Mahmood, Mohammed M. AlGhamdi, Mohammad O. AlQithmi, Nasser M. Faris, Muhammad U. Nasir and Ali Salman
Saudi Medical Journal January 2024, 45 (1) 74-78; DOI: https://doi.org/10.15537/smj.2024.45.1.20230674
Faisal T. Mahmood
From the Department of Emergency (Mahmood, AlQithmi), King Fahad Specialist Hospital, Dammam, from the Department of Emergency (AlGhamdi), Johns Hopkins Aramco Healthcare, Dhahran, from the Department of Emergency (Faris), Armed Forces Hospital, Jazan, Kingdom of Saudi Arabia, from the Department of Internal Medicine (Nasir), King Edward Medical University, Lahore, and from the Department of Internal Medicine (Salman), Dow University of Health Sciences, Karachi, Pakistan.
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  • ORCID record for Faisal T. Mahmood
  • For correspondence: [email protected]
Mohammed M. AlGhamdi
From the Department of Emergency (Mahmood, AlQithmi), King Fahad Specialist Hospital, Dammam, from the Department of Emergency (AlGhamdi), Johns Hopkins Aramco Healthcare, Dhahran, from the Department of Emergency (Faris), Armed Forces Hospital, Jazan, Kingdom of Saudi Arabia, from the Department of Internal Medicine (Nasir), King Edward Medical University, Lahore, and from the Department of Internal Medicine (Salman), Dow University of Health Sciences, Karachi, Pakistan.
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Mohammad O. AlQithmi
From the Department of Emergency (Mahmood, AlQithmi), King Fahad Specialist Hospital, Dammam, from the Department of Emergency (AlGhamdi), Johns Hopkins Aramco Healthcare, Dhahran, from the Department of Emergency (Faris), Armed Forces Hospital, Jazan, Kingdom of Saudi Arabia, from the Department of Internal Medicine (Nasir), King Edward Medical University, Lahore, and from the Department of Internal Medicine (Salman), Dow University of Health Sciences, Karachi, Pakistan.
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Nasser M. Faris
From the Department of Emergency (Mahmood, AlQithmi), King Fahad Specialist Hospital, Dammam, from the Department of Emergency (AlGhamdi), Johns Hopkins Aramco Healthcare, Dhahran, from the Department of Emergency (Faris), Armed Forces Hospital, Jazan, Kingdom of Saudi Arabia, from the Department of Internal Medicine (Nasir), King Edward Medical University, Lahore, and from the Department of Internal Medicine (Salman), Dow University of Health Sciences, Karachi, Pakistan.
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Muhammad U. Nasir
From the Department of Emergency (Mahmood, AlQithmi), King Fahad Specialist Hospital, Dammam, from the Department of Emergency (AlGhamdi), Johns Hopkins Aramco Healthcare, Dhahran, from the Department of Emergency (Faris), Armed Forces Hospital, Jazan, Kingdom of Saudi Arabia, from the Department of Internal Medicine (Nasir), King Edward Medical University, Lahore, and from the Department of Internal Medicine (Salman), Dow University of Health Sciences, Karachi, Pakistan.
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Ali Salman
From the Department of Emergency (Mahmood, AlQithmi), King Fahad Specialist Hospital, Dammam, from the Department of Emergency (AlGhamdi), Johns Hopkins Aramco Healthcare, Dhahran, from the Department of Emergency (Faris), Armed Forces Hospital, Jazan, Kingdom of Saudi Arabia, from the Department of Internal Medicine (Nasir), King Edward Medical University, Lahore, and from the Department of Internal Medicine (Salman), Dow University of Health Sciences, Karachi, Pakistan.
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Article Figures & Data

Tables

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    Table 1

    - Demographics of the patient’s included in the study (N=7,826).

    CharacteristicOverall (N=7,826)MonthsP-values*
    August (n=2,854)September (n=2,321)October (n=2,651)
    Age, median (IQR)45 (30-59)45 (30-60)44 (30-59)45 (29-59)0.2
    Gender
    Female4,260 (54.0)1,505 (53.0)1,298 (56.0)1,457 (55.0)0.058
    Male3,566 (46.0)1,349 (47.0)1,023 (44.0)1,194 (45.0)
    Nationality
    Non-Saudi340 (4.3)107 (3.7)110 (4.7)123 (4.6)0.15
    Saudi7,486 (96.0)2,747 (96.0)2,211 (95.0)2,528 (95.0)
    CTAS
    Resuscitation10 (0.1)1 (<0.1)3 (0.1)6 (0.2) 
    Emergent85 (1.1)35 (1.2)21 (0.9)29 (1.1) 
    Urgent4,009 (51.0)1,435 (50.0)1,132 (49.0)1,442 (54.0) 
    Less urgent3,277 (42.0)1,171 (41.0)1,085 (47.0)1,021 (39.0) 
    Non-urgent445 (5.7)212 (7.4)80 (3.4)153 (5.8) 
    Patient’s type     
    Active6,928 (89.0)2,507 (88.0)2,034 (88.0)2,387 (90.0)0.001
    Dependent131 (1.7)39 (1.4)51 (2.2)41 (1.5)
    Employee285 (3.6)109 (3.8)82 (3.5)94 (3.5)
    New patient404 (5.2)171 (6.0)135 (5.8)98 (3.7)
    Non-active77 (1.0)27 (0.9)19 (0.8)31 (1.2)

    Values are presented as numbers and precentages (%) or median interquartile range (IQR).

    CTAS: Canadian triage and acuity scale

    • ↵* Kruskal-Wallis rank sum test; Pearson’s Chi-squared test.

    • View popup
    Table 2

    - Objectives of the study (N=7,826).

    CharacteristicOverall (N=7,826)MonthsP-values*
    August (n=2,854)September (n=2,321)October (n=2,651)
    Left without being seen, n(%)140 (1.8)64 (2.2)53 (2.3)23 (0.9)<0.001
    Time to physician (mins)30 (16-52)31 (16-59)31 (18-53)27 (15-46)<0.001
    Time to disposition decision (mins)133 (59-230)135 (60-238)130 (62-223)132 (55-228)0.5
    Length of stay (mins)140 (60-256)142 (62-263)137 (64-245)139 (57-260)0.9

    Values are presented as numbers and precentages (%) or median interquartile range (IQR).

    • ↵* Kruskal-Wallis rank sum test; Pearson’s Chi-squared test. mins: minutes

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The effect of having a physician in the triage area on the rate of patients leaving without being seen
Faisal T. Mahmood, Mohammed M. AlGhamdi, Mohammad O. AlQithmi, Nasser M. Faris, Muhammad U. Nasir, Ali Salman
Saudi Medical Journal Jan 2024, 45 (1) 74-78; DOI: 10.15537/smj.2024.45.1.20230674

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The effect of having a physician in the triage area on the rate of patients leaving without being seen
Faisal T. Mahmood, Mohammed M. AlGhamdi, Mohammad O. AlQithmi, Nasser M. Faris, Muhammad U. Nasir, Ali Salman
Saudi Medical Journal Jan 2024, 45 (1) 74-78; DOI: 10.15537/smj.2024.45.1.20230674
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