• Michael R P de la Roche, Mark Froats, Allen Bell, Lois McDonald, Craig Bolton, Rob Devins, Ryan Hall, Jonathan Leclerc, Jann Istead, Michele Miron, Martin Badowski, Tracy Steinitz, Nathan King, and Priyanka Gogna.
• Active staff members at Quinte Health Care in Belleville, Ont. MRP.delaroche@gmail.com.
• Can Fam Physician. 2021 Feb 1; 67 (2): 114-120.

ObjectiveTo determine whether changes to the appearance of an emergency department (ED) waiting room influenced the number of patients who left without being seen (LWBS).DesignRetrospective analysis using National Ambulatory Care Reporting System data collected at the time of patient registration.SettingThe ED of Belleville General Hospital, a mid-sized secondary care community hospital in Ontario with a catchment population of 125 000.ParticipantsAll unscheduled patients registering at the hospital to be seen in the ED from July 1 to December 31, 2016 (control period), and from July 1 to December 31, 2017 (study period).Main Outcome MeasuresThe volume of patients registering by Canadian Triage and Acuity Scale (CTAS) level to be seen in the ED during the study period compared with the volume of patients registering during the control period, and the number of LWBS during the 2 time periods.ResultsThe average number of patients registered per month was significantly greater in the study period than in the control period (t 10 = -5.53, P < .01). A total increase of 1881 registrations was recorded in the study period, or 10.47% (increase per month ranged from 9.59% to 11.66%). The proportion of patients with less acute triage scores decreased in the study period; however, the differences in CTAS levels between the 2 years was not statistically significant (χ 2 = 1.05, P = .90). The number of LWBS according to CTAS level was lower in all categories in the study period, including those in the less acute levels, decreasing from 60 in CTAS 5 in 2016 to 45 in 2017, and 585 in CTAS 4 in 2016 to 330 in 2017. Overall, the distribution of LWBS by CTAS level was significantly different between the control and study periods (P < .01).ConclusionThe number of patients registering is influenced by the apparent high or low occupancy of the waiting area at the time of registration.Copyright © the College of Family Physicians of Canada.

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