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To determine if the time of the academic year affects door-to-disposition time for patients presenting to our obstetric triage unit.
Triage records for 1813 patients at a tertiary academic center in July, December and June of two consecutive academic years, 2008 and 2009, were examined. The patients were triaged to one of three levels of acuity: emergent, urgent, and non-urgent. Admitted patients were excluded. Disposition times were compared across the academic year time periods at a particular acuity level with ANOVA and Kruskal-Wallis test as appropriate. Weekday versus weekend visits were evaluated using independent student t-test or Kolmogorov-Smirnov test. P was set at 0.05.
Over two academic years, there were 590 triage visits in May, 611 in July and 612 visits in December. Emergent, urgent, and non-urgent acuity levels represented 3.3%, 79.9%, and 16.8% of visits, respectively. When evaluating acuity across the months, a statistically significant difference was seen in disposition time (Table 1). Overall visit time significantly decreased between July, December and May (p<0.001). Pairwise comparisons were significantly different for urgent visits between July and May (p<0.001) and December and May (p<0.001). For non-urgent visits, pairwise comparisons were significant between July and May (p<0.05). A significant overall difference in disposition time across months was found for weekdays for urgent acuity (p<0.001, Table 4). No significant differences in disposition time between weekdays and weekends were found for any month at any acuity level. No significant overall differences in disposition time across months were found for weekdays or weekends for emergent acuity visits.
There was a continual decrease in door-to-disposition time over the academic year. This suggests that there is a “July Effect” with respect to the most common triage visits and that the month in the academic year does influence the length of triage visits in our cohort.