Exploring patient characteristics and departmental factors for those who 'did not wait' to be seen and treated in the emergency department - the DNW study.

BACKGROUND

Patients who did not wait (DNW) for care in Emergency Departments (EDs) are individuals who present seeking treatment but leave before medical assessment. This cohort is an important focus for emergency research, as DNW events may reflect barriers to timely care, pose clinical and safety risks, and provide insight into broader system pressures within emergency services.

METHODS

Retrospective study of DNW patients presenting to a metropolitan tertiary ED between January 1 and December 31, 2023. Descriptive statistics were generated for clinical and treatment variables, and multivariate logistic regression explored factors influencing 48-hour hospital representation.

RESULTS

In total, 813 DNW patients were identified, representing approximately 1% of triaged patients. Most arrived by private transport and were allocated low-priority triage categories. Whilst 4% of cases had their presenting complaint completely managed by triage nursing staff, only 1.4% received nurse-initiated investigation or treatment. Overall, 9% represented to a local health district ED within 48 h. Multivariate logistic regression did not identify clinical factors significantly associated with subsequent hospital representation.

CONCLUSION

DNW patients are common and frequently represent to other facilities to address healthcare needs. Earlier nurse-initiated treatments may accelerate patient care and potentially reduce DNW cases; however, this requires further research.