| CTAS Level Table | ||
|---|---|---|
| Data from 11/1/2024 to 11/30/2024 | ||
| CTAS Level | Patients Visits | Percentage |
| 1 | 11 | 0.19% |
| 2 | 106 | 1.79% |
| 3 | 3,174 | 53.52% |
| 4 | 2,203 | 37.15% |
| 5 | 436 | 7.35% |
| Overall Total | 5,930 | 100.00% |
This comprehensive report examines emergency department (ER) operations, focusing on critical key performance indicators (KPIs) that reflect the efficiency and effectiveness of patient care from triage to treatment.
Introduction
The Taif Children’s Hospital Emergency Department for November 2024 reveals critical operational insights. With 5,930 patient visits, the department experienced a notable -39% decrease from October’s volume. Despite this reduction, key performance indicators show mixed results: improved initial response times but increased disposition delays. The emergency department maintained a balanced urgent/non-urgent case ratio of 55/45, with a high door-to-disposition completion rate of 98%.
Patients Visits
The number of patient visits has significantly decreased compared to the previous month October, indicating a substantial reduction in ED demand.
Key Metrics Overview:
- Total Patients Visits: 5,930 (-39% decrease from October)
- Busiest Day: Saturday (1,109 Patients) Peak at 12 AM
- Peak Visit Hours: 5PM (350 Patients)
- Highest Patients Volume: November 23, with 248 Patients Visits.
- Average Door to Doctor: 12 Minutes
- Average Doctor to Decision: 24 Minutes
- Door To Disposition: 98%
- Non-Urgent:45%
- Admitted: 374(6%) and Not-Admitted: 5,556(94%)
- LAMA & DAMA: 1.40%
- Mortality Rate: 0.02% (1 Deceased Patients)
An anatomical color-coded triage system dividing patient care into 5 Distinct Parts:
- Level 1: Resuscitation
- Level 2: Emergent care
- Level 3: Urgent cases
- Level 4: Less-Urgent
- Level 5: Non-Urgent
Patient Volume Distribution::
- CTAS 3 patients constitute the majority of visits (53%)
- CTAS 4 patients are the second largest group (37%)
- CTAS 1 and CTAS 2 (highest acuity) represent less than 2% of total volume.
- CTAS 5 (lowest acuity) accounts for about 7% of visits.
Observations:
- Dominant Colors:
- Yellow and green dots are the most common in the distribution, suggesting these CTAS levels have the highest patient volume.
- Least Common Colors:
- Red and light gray dots are scattered sparsely, indicating these CTAS patient categories are less frequent.
- Central Black Point:
- The black center may represent the highest acuity or the focal point of triage, with fewer patients categorized as such.
Pattern Insights:
The spiral pattern reflects a graded distribution of patients, potentially indicating a continuum of urgency levels.
Larger dots may represent more frequent cases, while smaller dots suggest less frequent cases.
The human figure captures the essential elements of how the anatomical regions correspond to different urgency levels, making it easy for healthcare providers to quickly classify and prioritize patient care needs.
The spiral distribution illustrates patient visits categorized by CTAS levels, with Yellow and Green dots (most common) representing lower-acuity cases and Red and Light Gray dots (least common) reflecting higher-acuity cases. The central black point signifies the critical urgency category. This pattern highlights the need to optimize resources for high-volume lower-acuity patients while ensuring adequate care for less frequent but critical cases.
Time Analysis
Peak Hours in the ER:
- 0:00 and 17:00 (350 Patients)
- 20:00 (332 Patients)
- 19:00 (328 Patients)
Lower Activity Period:
- 5:00 (122 patients)
- 4:00 (148 patients)
- 6:00 (166 patients)
The 24 hour clock represents hourly patient visits to an emergency room (ER) categorized by CTAS levels 1 through 5. The analysis focuses on patient volume distribution and peak times, with the aim of optimizing ER performance.
Peak Hours: (Midnight and Evening)
These peaks require maximum staffing and resource allocation.
- The highest number of visits (350) occurs at both 12 AM (midnight) and 5 PM.
Low Activity Period (Early Morning)::
These periods may be suitable for staff breaks and shift changes.
- The lowest number of visits happens around 4 AM to 6 AM, indicating reduced patient flow during early morning hours.
Midday Recovery Trend:
Patient visits gradually rise after 6 AM, stabilize around midday, and peak again by late afternoon. This highlights:
- The importance of adequate staffing during the 9 AM–5 PM window, aligning with consistent patient flow.
- Consider staggered shifts to prevent staff burnout during extended busy periods.
Admission
| Admission and Discharge Table | ||
|---|---|---|
| 11/1/2024 - 11/30/2024 | ||
| Admission | Total | Percentage |
| NICU | 44 | 0.74% |
| PICU | 63 | 1.06% |
| Ward | 267 | 4.50% |
| DAMA | 83 | 1.40% |
| Deceased | 1 | 0.02% |
| Home | 5,472 | 92.28% |
| Admission Key Metrics | ||||
|---|---|---|---|---|
| KPI Summary from 11/1/2024 - 11/30/2024 | ||||
| Admission | Patient Visits | Door to Doctor | Doctor to Decision | Decision to Disposition |
| NICU | 44 | 0:20 | 0:28 | 0:24 |
| PICU | 63 | 0:18 | 0:26 | 0:24 |
| Ward | 267 | 0:15 | 0:30 | 1:11 |
| Grand Total | 374 | 0:16 | 0:29 | 0:58 |
| KPI Benchmark: ■ World Class, ■ Acceptable, ■ Needs Improvement, ■ Unacceptable | ||||
| Discharge Key Metrics | ||||
|---|---|---|---|---|
| KPI Summary from 11/1/2024 - 11/30/2024 | ||||
| Discharge | Patient Visits | Door to Doctor | Doctor to Decision | Decision to Disposition |
| DAMA | 83 | 0:22 | 0:33 | 0:51 |
| Deceased | 1 | 0:10 | 0:22 | 0:31 |
| Home | 5,472 | 0:12 | 0:23 | 0:36 |
| Grand Total | 5,556 | 0:12 | 0:23 | 0:36 |
| KPI Benchmark: ■ World Class, ■ Acceptable, ■ Needs Improvement, ■ Unacceptable | ||||
Disposition
| Decision to Disposition (Avg. Minute) | ||||||
|---|---|---|---|---|---|---|
| 11/1/2024 - 11/30/2024 | ||||||
| CTAS Level | DAMA | Deceased | Home | NICU | PICU | Ward |
| 1 | - | 0:31 | 0:23 | 0:15 | 0:20 | - |
| 2 | 1:24 | - | 0:48 | 0:20 | 0:27 | 0:41 |
| 3 | 0:46 | - | 0:45 | 0:33 | 0:22 | 1:15 |
| 4 | 1:43 | - | 0:26 | 0:40 | - | 0:47 |
| 5 | - | - | 0:27 | - | - | 2:00 |
| Grand Total | 0:51 | 0:31 | 0:36 | 0:24 | 0:24 | 1:11 |
| KPI Benchmark: ■ World Class, ■ Acceptable, ■ Needs Improvement, ■ Unacceptable | ||||||
| Decision to Disposition (Total Patients) | ||||||
|---|---|---|---|---|---|---|
| Admission and Discharge Volume | ||||||
| CTAS Level | DAMA | Deceased | Home | NICU | PICU | Ward |
| 1 | - | 1 | 2 | 1 | 7 | - |
| 2 | 5 | - | 24 | 30 | 28 | 19 |
| 3 | 75 | - | 2,828 | 11 | 28 | 232 |
| 4 | 3 | - | 2,183 | 2 | 15 | - |
| 5 | - | - | 435 | - | 1 | - |
| Grand Total | 83 | 1 | 5,472 | 44 | 63 | 267 |
| Decision to Disposition Volume (%) | ||||||
|---|---|---|---|---|---|---|
| Admission and Discharge (Percentage) | ||||||
| CTAS Level | DAMA | Deceased | Home | NICU | PICU | Ward |
| 1 | 0.00% | 0.02% | 0.03% | 0.02% | 0.12% | 0.00% |
| 2 | 0.08% | 0.00% | 0.40% | 0.51% | 0.47% | 0.32% |
| 3 | 1.26% | 0.00% | 47.69% | 0.19% | 0.47% | 3.91% |
| 4 | 0.05% | 0.00% | 36.81% | 0.03% | 0.00% | 0.25% |
| 5 | 0.00% | 0.00% | 7.34% | 0.00% | 0.00% | 0.02% |
| Grand Total | 1.40% | 0.02% | 92.28% | 0.74% | 1.06% | 4.50% |
| Disposition Within an Hour | ||
|---|---|---|
| Aggregated Occurrences and Percentage | ||
| Disposition Hour | Number of Occurrences | Percentage (%) |
| 0 | 2,543 | 42.88% |
| 1 | 2,800 | 47.22% |
| 2 | 287 | 4.84% |
| 3 | 165 | 2.78% |
| 4 | 89 | 1.50% |
| 5 | 28 | 0.47% |
| 6 | 10 | 0.17% |
| 7 | 5 | 0.08% |
| 8 | 2 | 0.03% |
| 9 | 1 | 0.02% |
Triage Away
Triage Away:
- Percentages vary daily, ranging from 11% to 29%, with peaks on dates 15/11/2024.
No Outcome:
- Percentages range between 0.6% and 16%, with occasional spikes.
Total ED Patients:
- Fluctuates between 261 and 364, indicating varying levels of patient traffic.
Total Admissions:
- Generally, admissions are lower compared to total ED visits, ranging between 5 and 22 admissions per day.
Average Admission Decision to Disposition (Minutes)
- Data is missing for some dates and ranges from 16 minutes to 52 minutes for dates where values are provided.
| Emergency Department Statistics - November 2024 | |||||||
|---|---|---|---|---|---|---|---|
| Summary of Triage Away, Outcomes, and Admissions | |||||||
| Date |
Triage Away
|
Outcome
|
Total ED Patients |
Total Admissions |
Avg Admission Dec to Dis (Minutes) |
||
| Triage Away | % | No Outcome | % | ||||
| 01/11/2024 | 49 | 15% | 18 | 5.57% | 323 | 9 | - |
| 02/11/2024 | 38 | 11% | 38 | 11% | 355 | 9 | - |
| 03/11/2024 | 57 | 19% | 28 | 9.45% | 296 | 9 | - |
| 04/11/2024 | 55 | 20% | 37 | 14% | 271 | 10 | - |
| 05/11/2024 | 56 | 20% | 31 | 11% | 278 | 7 | - |
| 06/11/2024 | 52 | 16% | 23 | 7.1% | 322 | 12 | - |
| 07/11/2024 | 46 | 16% | 12 | 4.2% | 284 | 11 | - |
| 08/11/2024 | 67 | 22% | 25 | 8% | 310 | 6 | 16 minutes |
| 09/11/2024 | 72 | 25% | 5 | 1.7% | 290 | 9 | 15 minutes |
| 10/11/2024 | 63 | 21% | 29 | 10% | 298 | 8 | 18 minutes |
| 11/11/2024 | 54 | 21% | 43 | 16% | 261 | 5 | 28 minutes |
| 12/11/2024 | 50 | 19% | 11 | 4% | 265 | 14 | 27 minutes |
| 13/11/2024 | 67 | 23% | 38 | 13% | 294 | 6 | 42 minutes |
| 14/11/2024 | 64 | 21% | 44 | 14% | 304 | 10 | - |
| 15/11/2024 | 93 | 29% | 4 | 1.25% | 320 | 15 | - |
| 16/11/2024 | 96 | 26% | 25 | 6.8% | 364 | 12 * | 32 minutes |
| 17/11/2024 | 43 | 13% | 2 | 0.6% | 326 | 22 * | 39 minutes |
| 18/11/2024 | 49 | 15% | 42 | 13% | 336 | 18 * | 52 minutes |
| 19/11/2024 | 50 | 14.5% | 55 | 16% | 345 | 12 * | 37 minutes |
| * Hover over cells with asterisk (*) to view additional details | |||||||
KPI Summary
The Emergency Department’s performance metrics indicate efficient patient flow across all CTAS levels. Of the 5,930 total visits, over 98% were CTAS 3-5 (lower acuity), with world class average times for Door to Doctor (0:12) and Doctor to Decision (0:24).
CTAS 1 (Critical): Metrics are within acceptable ranges, reflecting prioritized care for the most critical cases.
CTAS 2 (Emergent): There is a slight lag in Door to Doctor average waiting time 0:22, suggesting an opportunity for process optimization in this category.
CTAS 3-5 (Lower Acuity): Exceptional performance, particularly in CTAS 5, with the shortest times recorded.
Overall, the department meets or exceeds performance benchmarks, with only minor improvements needed in specific areas in CTAS 2.
| Emergency Department Key Metrics | |||||
|---|---|---|---|---|---|
| KPI Summary from 11/1/2024 - 11/30/2024 | |||||
| CTAS Level | Patient Visits | Percentage | Door to Doctor | Doctor to Decision | Decision to Disposition |
| 1 | 11 | 0.19% | 0:19 | 0:36 | 0:21 |
| 2 | 106 | 1.79% | 0:22 | 0:32 | 0:35 |
| 3 | 3,174 | 53.52% | 0:12 | 0:25 | 0:47 |
| 4 | 2,203 | 37.15% | 0:12 | 0:23 | 0:26 |
| 5 | 436 | 7.35% | 0:10 | 0:18 | 0:27 |
| Grand Total | 5,930 | 100% | 0:12 | 0:24 | 0:37 |
| KPI Benchmark: ■ World Class, ■ Acceptable, ■ Needs Improvement, ■ Unacceptable | |||||
Key Insights:
The department excels in managing high patient volumes, particularly in CTAS 3-5. Most metrics are in the acceptable range, though there is one area that needs improvement and some that achieve world-class status
Conclusion
While overall patient volume decreased significantly (-39%), the hospital improved efficiency in initial patient processing (Door to Doctor and Doctor to Decision times). However, the increased Decision to Disposition time needs attention as it’s creating a bottleneck in patient flow. The low DAMA rates and high disposition success highlight effective patient management and adherence. The low mortality rate (0.02%) suggests quality care despite high patient volumes.