ANALISIS FAKTOR YANG MEMPENGARUHI LENGTH OF STAY PASIEN DI INSTALASI GAWAT DARURAT MENGGUNAKAN PENDEKATAN TIME FRAME GUIDE EMERGENCY MODEL OF CARE

Introduction: Length of stay (LOS) in emergency department (ED) was an important indicator of the patient throughput process in ED. Prolonged LOS caused crowding that was associated with increased sentinel events, delayed treatmens, increased mortality and prolonged hospital length of stay. The analysis and identification of dominant factors affecting the patient throughput process in the ED could be solution crowding problems and the prevention of adverse impacts. Method: This study was used Analytical descriptive with cross sectional design. 172 respondents, aged ≥18 years, was taken by consecutive sampling. ED length of stay was measured as dependent variable. The time for the ED assessment, the time for review or consultation and the waiting time for inpatient bed was measured as independent variables. Statistical analysis was used multiple logistic regression tests. Results: The results showed the average length of stay patient in ED of Soetomo hospital was 9 hours and 35 minutes. The time for review and consultation (time frame 2) was prolongest among other time frames, spent less than a half of ED LOS (44%). The regression analysis test showed pValue = 0.001 ( ≤ 0.05) for the ED assessment, p Value = 0,000 for the review or consultation and p Value = 0.002 for the waiting time for the inpatient unit. Analysis: The time for review and consultation in time frame 2 is the most lengthening and dominant influence ED LOS, due to layered consultation procedure, repeated diagnostic test and evaluation in ED. Discussion: Time for ED assessment, time for review/consultation and waiting time for inpatient bed are important variables affecting LOS. By controlling the time of the three variables in the time frame guide can achieve the desired LOS ED target