Use of the log book in a quality assurance exercise in an hospital emergency department in Barbados - abstract

ABSTRACT

Patients with bronchial asthma account for about 13 per cent of all patients attending the Accident and Emergency Department, Queen Elizabeth Hospital, Barbados. They are given high priority and departmental policy requires that they should be admitted within 4-6 hours if improvement is unsatisfactory. During the period January to March, 1989, all patients with a final diagnosis of asthmatic attack had recorded in a log book personal identification data, date and time of arrival, and times when seen, discharged or transferred, and the results were analysed by computer. The aim of this retrospective study was to monitor how closely departmental policy was adhered to with respect to these patients. A total of 1,792 visits were made by 1,079 asthmatic patients, 57 per cent males and 43 per cent females. Sixty per cent of patients were less than 15 years of age and 11 per cent did not have their ages recorded. In only 13 per cent of cases was the time the patient was seen recorded and the average waiting time for these patients was 36 minutes. Thirty-two percent of cases were discharged or admitted within 3 hours; 31 per cent between 3 and 6 hours; 15 per cent between 6 and 9 hours; and 22 per cent waited for more than 9 hours for final disposal. It is concluded that the objectives set out for care of asthmatics were mostly not met, greater effort is required to ensure that patients' ages and time when seen by attending staff are recorded and that the log book is a useful tool to monitor a quality assurance programme (AU)