Description
PROPOSAL
On
The Effect of Emergency Department Wait Times on
Patient Mortality: A Systematic Review
By
[Your Full Name Here]
Enrolment No. xxxxxxx
[Insert Degree Name]
[Insert Department Name]
[Insert Name of College]
[Insert Course Code: xxxxx]
[Insert Branch Name]
Date of Submission: DD MM 20YY
Supervisor Name:
Dr. Xxx Xxxxxxx Xxxxx
Saudi Electronic University
1. Background
Emergency department (ED) wait times have evolved into a central public health issue after
researchers proved that long wait times lead to negative patient results including death (Nyce et
al., 2021). Critical illnesses are delayed because overcrowding affects resources and the
effectiveness of triage procedures which create prolonged waiting times (Nyce et al., 2021). The
World Health Organization (WHO) together with national health agencies recognize ED
overcrowding as a worldwide healthcare problem which affects both developed and developing
healthcare systems (Sartini et al., 2022). Waits at emergency departments become longer because
of increasing patient numbers together with inadequate medical staff and suboptimal hospital
processes thus delaying essential treatments while straining emergency response systems. For
instance, many nations including Saudi Arabia experiences increased ED pressure due to rising
chronic disease cases and growing emergency department visits. Delayed urgent medical care
creates potential risks for patients that could deteriorate their treatment outcomes (Caswell &
Kenkre, 2021). Multiple studies confirm that extended emergency department waiting times
produce adverse patient results such as elevated mortality rate and prolonged hospitalization
periods and increased disease severity. Medical survival rates show decreased chances because
patients require delayed timely medical care for myocardial infarctions strokes and sepsis.
Research on patient survival during emergency department wait times continues to expand yet it
still lacks clarity about dangerous wait time thresholds and risk variations between groups and
successful methods to shorten waiting periods and boost survival rates (Légaré et al., 2018).
Enhancing emergency care requires solving these difficulties to achieve better patient results and
better policies that optimize ED efficiency throughout the world.
2. Statement of the problem
Prolonged Emergency department (ED) waiting durations have evolved into a critical public health
matter since they lead to deteriorating patient results through higher mortality and morbidity rates.
Hospitals face prolonged wait times because patients face overcrowding conditions and the health
facility lacks adequate resources along with faulty triage processes and hospital flow procedures.
The relationship between patient health outcomes and wait times has received extensive research
but researchers have not determined specific dangerous delays or the differences between different
patient populations. Various healthcare organizations treat different patient groups using different
protocols which makes it difficult to establish standard waiting periods that all facilities should
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follow. The survival prognosis of patients who need urgent medical attention for myocardial
infarcts and strokes or sepsis treatment deteriorates when their waiting period exceeds safe
parameters. Medical facilities have implemented multiple ED congestion reduction methods yet a
more comprehensive research is needed to validate their impact on reducing patient mortality rates.
3. Literature Review
Multiple research investigations have studied emergency department (ED) wait
time effects on patient results through evaluations that measured mortality rates and extra adverse
events. The findings of Chau et al. (2024) showed that vital patients faced higher death rates when
they spent longer periods in emergency departments. Myocardial infarction and sepsis patients
under delayed medical care displayed increased mortality rates based on the research findings
(Chau et al., 2024).
The research conducted by Alenezi et al. (2021) and Darraj et al. (2023) proves that ED
overcrowding alongside delayed patient care produces adverse medical outcomes that lead to
longer hospital stays and more severe patient conditions. The results from the examined research
show that prolonged patient waiting periods cause severe health complications thus proving that
effective triage strategies and proper resource management are essential. (Alenezi et al., 2021;
Darraj et al., 2023)
The research from Byrne et al. (2018) created divergent findings regarding disease-specific
unfavorable results and uncertain death rates across various patient groups. Patient survival data
varies because hospital protocols and treatment delays and patient demographics seem to influence
wait time impact on mortality (Byrne et al., 2018; Moscelli et al., 2016).
The research conducted by Bonamigo et al., (2024) investigated different methods to
shorten emergency department waiting times. Bonamigo et al., (2024) documented that faster
healthcare processes and adding more medical personnel would decrease waiting times and lead
to better medical results (Bonamigo et al., 2024). This literature demonstrates insufficient research
into the effectiveness of mortality reduction through these intervention strategies even though it
establishes a clear research gap.
Research shows that ED wait time impacts patient outcomes remains established fact yet
scientists still need to discover both critical threshold points where delays turn deadly along with
methods to minimize these fatal risks.
4. Project Objectives
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The objectives of this project are as follows:
To review existing literature on the relationship between ED wait times and patient mortality.
To identify the critical wait time thresholds associated with increased mortality risk for high-acuity
patients.
To evaluate the effectiveness of interventions aimed at reducing ED wait times.
To provide recommendations for improving ED efficiency and reducing mortality rates.
5. Target Population (Sampling Technique and Sample Size)
Scholarly articles, research studies, and clinical reports that investigate emergency department
(ED) wait times and patient mortality serve as the target population for this study. The chosen
sources concentrate on treatment of myocardial infarctions together with strokes and sepsis
because early medical care directly impacts patient survival. The research includes studies from
diverse healthcare settings which combine high- and low-resource environments to deliver
widespread understanding of the topic. The research will utilize between thirty and fifty sources
consisting of peer-reviewed journals together with clinical guidelines and hospital reports. The
selection process for sources will prioritize those sources which match the research inquiry while
offering high-quality data regarding ED wait time-related mortality outcomes. Studies using
purposive sampling techniques will be chosen because they present the connection between ED
wait times and patient mortality. The selection method proves suitable because researchers can
incorporate studies which directly address the research question and deliver significant insights.
6. Data Collection Approach
Secondary data collection will be performed by analyzing existing research studies and literature
which investigates the effects of emergency department (ED) wait times on patient mortality. The
research will perform a systematic search through databases PubMed and Scopus and Google
Scholar by using the search terms “ED wait times” and “patient mortality” and “delayed treatment”
and “high-acuity conditions.” The research will include only peer-reviewed articles and clinical
studies from credible health organization reports which focus on mortality studies regarding wait
times especially for myocardial infarctions strokes and sepsis. Selected article references will also
be consulted to discover any studies that were not included during the initial search. Each source
will provide data that includes study design information as well as sample size details and patient
demographics and wait times and mortality outcomes. The chosen methodology enables
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researchers to find existing patterns and missing areas in the literature base regarding the
relationship between emergency department wait times and patient survival rates.
7. Data Analysis
The study will use qualitative methods to evaluate the data because it depends on secondary
research materials from existing literature. The research will investigate main patterns and trends
in ED wait time relationships to patient mortality outcomes specifically among high-acuity patient
groups. The research data will appear as tables together with figures and charts for better visual
representation of the results. All essential statistics regarding wait times together with mortality
data alongside intervention results will be presented in easily understandable tables. The
distribution of patient demographic and healthcare setting outcomes will be displayed through
graph and pie chart representations. The data interpretation will utilize thematic analysis which
establishes wait time threshold and intervention impact categories. The research will use SPSS and
Excel to develop data organization but the analysis will primarily involve qualitative synthesis of
data from chosen studies. The research findings will be logically structured according to each
research objective..
8. Potential Scope of the Project
This study’s findings will benefit numerous stakeholders. The research establishes a complete
representation of ED wait time-patient mortality connections to clarify known deficiencies and
identify new study directions. The research findings enable healthcare managers and policymakers
to develop better methods for decreasing ED overcrowding and enhancing patient outcomes which
supports their decisions regarding resource management and workflow improvements. Emergency
physicians and nurses as well as other practitioners can use evidence-based guidance to implement
quick interventions that enhance patient care and minimize death risks. Furthermore, the results
can help hospital administrators assess their current wait time reduction plans and direct their
investment choices toward essential improvements that enhance both ED efficiency and patient
survival outcomes.
9. Project Implementation Plan
Indicate in the form of a Gantt chart, the expected project start date, the duration of some important
phases/activities and also indicate the tentative project end date and total duration of the project.
Please refer to the approved thesis template in case you require further clarification of its content.
Time Frame
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Activities
Duration
(Days)
( 1st September 2022 to
November 2022 )
Proposal
Literature Review
Data collection
Report writing
Submission of final
Report
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References
1.
Alenezi, abdulrahman Ramadhan, Aldhafeeri, F. S., Alharbi, sanad Samah, Alotaibi, bader Naif, Alenezi,
meshal Falah, Almutairi, saif Helal, Alshmari, ahmed Saer, Alanazi, mohammed Ayyat, & Alanzi, A. A.
N. (2021). Emergency department overcrowding: Causes, impacts, and strategies for effective
management. International
Journal
of
Health
Sciences
(IJHS), 5(S1),
1219–1236.
2.
Bonamigo, A., Rodrigues, L. E. D. E. M., Chaves, S. M. D. O. A., Viera, L. E. V., & Calado, R. D. (2024).
Fast Track method for reducing Emergency Department Overcrowding. Anais Do Encontro Nacional de
Engenharia de Produção.
Byrne, D., Browne, J. G., Conway, R., Cournane, S., O’Riordan, D., & Silke, B. (2018). Mortality outcomes
and emergency department wait times – the paradox in the capacity limited sytem. Acute Medicine, 17(3),
130–136.
Caswell, A., & Kenkre, J. (2021). Primary healthcare in Saudi Arabia: An evaluation of emergent health
trends. Global Journal on Quality and Safety in Healthcare, 4(3), 96–104.
Chau, E. Y. W., Bakar, A. A., Zamhot, A. B., Zaini, I. Z., Binti Adanan, S. N., & Sabardin, D. M. B. (2024).
An observational study on the impact of overcrowding towards door-to-antibiotic time among sepsis
patients presented to emergency department of a tertiary academic hospital. BMC Emergency
Medicine, 24(1).
Darraj, A., Hudays, A., Hazazi, A., Hobani, A., & Alghamdi, A. (2023). The association between
emergency department overcrowding and delay in treatment: A systematic review. Healthcare (Basel,
Switzerland), 11(3), 385.
Légaré, F., Adekpedjou, R., Stacey, D., Turcotte, S., Kryworuchko, J., Graham, I. D., Lyddiatt, A., Politi,
M. C., Thomson, R., Elwyn, G., & Donner-Banzhoff, N. (2018). Interventions for increasing the use of
shared decision making by healthcare professionals. Cochrane Database of Systematic Reviews, 7(7),
CD006732.
Moscelli, G., Siciliani, L., & Tonei, V. (2016). Do waiting times affect health outcomes? Evidence from
coronary
bypass. Social
Science
&
Medicine
(1982), 161,
151–159.
Nyce, A., Gandhi, S., Freeze, B., Bosire, J., Ricca, T., Kupersmith, E., Mazzarelli, A., & Rachoin, J.-S.
(2021). Association of emergency department waiting times with patient experience in admitted and
discharged
patients. Journal
of
Patient
Experience, 8,
23743735211011404.
Sartini, M., Carbone, A., Demartini, A., Giribone, L., Oliva, M., Spagnolo, A. M., Cremonesi, P., Canale,
F., & Cristina, M. L. (2022). Overcrowding in Emergency Department: Causes, consequences, and
solutions-A
narrative
review. Healthcare
(Basel,
Switzerland), 10(9),
1625.
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