DIFFUSE DEGENERATION OF THE CEREBRAL WHITE MATTER IN SEVERE DEMENTIA FOLLOWING HEAD INJURY

Abstract

<h3>Objectives</h3> The 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. <h3>Methods</h3> A combination of data sources was reviewed: a ‘realistic’ literature review, analysis of hospital episode statistics data from England and a local NHS trust audit. <h3>Major Findings</h3> LWBS 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. <h3>Conclusions</h3> LWBS 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.