Did Not Wait Patient Management Strategy (DNW PMS) Study

Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists9 review of all ‘did not wait’ (DNW) patients9 triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients9 triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients9 triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.