Austin Health

Title
Emergency medicine patient wait time multivariable prediction models: a multicentre derivation and validation study.
Publication Date
2022-05
Author(s)
Walker, Katie
Jiarpakdee, Jirayus
Loupis, Anne
Tantithamthavorn, Chakkrit
Joe, Keith
Ben-Meir, Michael
Akhlaghi, Hamed
Hutton, Jennie
Wang, Wei
Stephenson, Michael
Blecher, Gabriel
Paul, Buntine
Sweeny, Amy
Turhan, Burak
Subject
efficiency
emergency care systems
emergency department management
emergency department operations
emergency department utilisation
emergency departments
Type of document
Journal Article
OrcId
0000-0002-5313-5852
0000-0001-8537-2011
0000-0001-8392-5612
DOI
10.1136/emermed-2020-211000
Abstract
Patients, families and community members would like emergency department wait time visibility. This would improve patient journeys through emergency medicine. The study objective was to derive, internally and externally validate machine learning models to predict emergency patient wait times that are applicable to a wide variety of emergency departments. Twelve emergency departments provided 3 years of retrospective administrative data from Australia (2017-2019). Descriptive and exploratory analyses were undertaken on the datasets. Statistical and machine learning models were developed to predict wait times at each site and were internally and externally validated. Model performance was tested on COVID-19 period data (January to June 2020). There were 1 930 609 patient episodes analysed and median site wait times varied from 24 to 54 min. Individual site model prediction median absolute errors varied from±22.6 min (95% CI 22.4 to 22.9) to ±44.0 min (95% CI 43.4 to 44.4). Global model prediction median absolute errors varied from ±33.9 min (95% CI 33.4 to 34.0) to ±43.8 min (95% CI 43.7 to 43.9). Random forest and linear regression models performed the best, rolling average models underestimated wait times. Important variables were triage category, last-k patient average wait time and arrival time. Wait time prediction models are not transferable across hospitals. Models performed well during the COVID-19 lockdown period. Electronic emergency demographic and flow information can be used to approximate emergency patient wait times. A general model is less accurate if applied without site-specific factors.
Link
Citation
Emergency medicine journal : EMJ 2022; 39(5): 386-393
Jornal Title
Emergency Medicine Journal : EMJ

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