Date of Conferral

2022

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Miriam Ross

Abstract

AbstractThe efficiency of the emergency department (ED) is important in the provision of quality patient care, which includes avoiding long wait times for tests and treatments. EDs may be overcrowded and understaffed, leading to increased wait times for tests. One of the areas overwhelmed by increased ED cases concerns the number of requests for computerized tomography (CT) scans, which may result in patients leaving the ED before care is completed. The three research questions for this quantitative study focused on the age of patients and CT scan walkout rates, completion time and CT scan walkout rates, and the number of CT tests requested and walkout rates. The independent variable was CT scans ordered in the ED. The dependent variables were the completion times for all patients, completion times based on age, and walkout rates. After the appropriate approvals, the dataset was obtained from a large medical center. The final dataset included 54,549 scan records, which originated in the ED during 2014 through 2019. A z test of proportion and chi-square test, together with a logistical regression analysis, were conducted to determine possible associations and statistical significance that addressed the research questions. The Donabedian model provided the foundation for this study and focused on how to improve quality, structure, and processes in the ED. Results from all three research questions showed a weak but relevant relationship and indicated the potential for a deeper study into why patients leave before their ED treatment was complete. This study may promote positive social change by providing healthcare administrators with an understanding of the significance surrounding CT scans being ordered and patients leaving before having them performed.

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