Anecdotal reports are positive, but the effect of this staffing plan on ED crowding, waiting times and LWBS proportions has yet to be formally studied. Limitations Although this was a retrospective analysis of a AMD3100 quality assurance database, all data were collected prospectively and an a priori objective of the database was to determine the proportion of patients who LWBS. Thus, the retrospective use of this database was unlikely to have led to significant bias. GPHC had not Inhibitors,research,lifescience,medical previously collected detailed patient characteristics at registration. This

data was initially collected for quality assurance purposes and GPHC administrators set the time limits on data collection. The database was Inhibitors,research,lifescience,medical collected over an isolated two-week time period. Ideally, we would have examined the LWBS proportion over a longer time period in order to eliminate seasonal variation or other causes of variation in LWBS proportions. However, accurate longer-term data regarding patients who LWBS or accurate demographic information are not currently available at GPHC. We excluded patients who were

sent from triage directly to a hospital clinic for care. It is possible that following these patients and including them in the analysis would have changed our results. Similarly, patients who presented for care but left prior Inhibitors,research,lifescience,medical to triage were not included in this study as no data could be obtained on these patients. Including these patients may have increased the LWBS proportion, but inclusion of these patients would also have made it difficult to compare our results with other published studies. Patients leaving before registration or triage are not typically reported in similar studies. Inhibitors,research,lifescience,medical Another limitation of this study was the lack of patient outcomes for those who LWBS. There was no mechanism to determine if patients who LWBS suffered other adverse events such as re-presentation to the ED, hospitalization, procedural interventions, or death. Finally, although this study was conducted at the primary referral hospital in a developing country, it may be difficult to generalize

Inhibitors,research,lifescience,medical these findings to other health care institutions in Guyana or in other developing countries. Conclusions The proportion of patients who LWBS is often used as a quality control Ketanserin indicator. There is a paucity of data on patients who LWBS in developing countries where those who LWBS may be more vulnerable to poor outcomes. As emergency care expands in developing nations, it is important to document LWBS proportions to develop appropriate quality control benchmarks and measure progress. The LWBS proportion at an urban, public hospital in Guyana, South America was found to be 5.7% with increased odds of LWBS associated with adult patients, presentation during the second shift, and presentation with non-traumatic conditions. This data provides useful information to develop strategies to decrease the number of patients who LWBS and can be followed over time to assess progress.