• A J Clarey and M W Cooke.
• Warwick Medical School, Coventry, UK. m.w.cooke@warwick.ac.uk
• Emerg Med J. 2012 Aug 1;29(8):617-21.

ObjectivesThe purpose of this review was to determine the rate of those that leave the emergency department (ED) without being seen and their reasons, to clarify if such behaviour poses a health risk, to analyse the impact initiatives have made on the leave without being seen (LWBS) rate, and to discuss the implications of using it as a national performance indicator within the NHS.MethodsA combination of data sources was reviewed: a 'realistic' literature review, analysis of hospital episode statistics data from England and a local NHS trust audit.Major FindingsLWBS rates vary across the world, from 15% to 0.36%. Also initiatives to reduce LWBS rates demonstrated mixed outcomes, with reductions in the rate by as much as 96%, while others were ineffective. The most common reason quoted for LWBS was long waiting times and there were few data to suggest LWBS posed a risk to patient health.ConclusionsLWBS is an issue experienced in many countries that has responded in a varying manner to many initiatives in attempts to reduce it; however, it is clearly associated with the waiting times experienced in ED and therefore working within a packet of performance measures it would assess the effect of waiting times from another perspective.

12 keywords...

hide…