Response Time, Decision Time, and Delivery Time in Pediatric Emergency Unit of West Java Top Referral Hospital

Ayu Sary Oktaviani, Dzulfikar D. Lukmanul Hakim, Suwarman Suwarman


Background: The number of visitors at pediatric emergency unit has increased around 25 million per year. This condition caused overcrowded in these units which would disrupt health care process. Waiting time is one indicator of health care quality. Prolonged waiting times is related to patient’s dissatisfaction and poor outcome. The aim of this study was to identify response time, decision time, and delivery time of Pediatric Emergency Unit in Dr. Hasan Sadikin General Hospital.

Methods: This was a descriptive cross sectional study. Data from medical records of pediatric patients who attend Pediatric Emergency Unit, Dr. Hasan Sadikin General Hospital from August to September 2015 were collected. The data included sex, age, day of admission, time of admission, insurance status, triage status, disposition of care, response time, decision time, and delivery time. The collected data were analyzed and presented in percentage and peformed in tables.

Results: A total of 201 data were collected during study period. The geometric mean of total waiting time in pediatric emergency department was 346.65 minutes (5 hours 46 minutes). Response time had a geometric mean of 4.07 minutes, meanwhile decision time and delivery time had geometric mean of 46.77 minutes and 181.97 minutes, respectively.

Conclusions: Total waiting times of pediatric emergency department exceeds the standard time (4 hours). Meanwhile response time and decision time have already met the standard. 


Decision time, delivery time, pediatric emergency unit, response time, waiting time

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Kroner EL, Hoffmann RG, Brousseau DC. Emergency department reliance: a discriminatory measure of frequent emergency department users. Pediatrics. 2010;125(1):133–8.

Middleton KR, Burt CW. Availability of pediatric services and equipment in emergency departments, United States, 2002-03. Adv Data. 2006;(367):1–16.

Tiwari Y, Goel S, Singh A. Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India. J Emerg Trauma Shock. 2014;7(3):160–5.

Harris A, Sharma A. Access block and overcrowding in emergency departments: an empirical analysis. Emerg Med J. 2010;27(7):508–11.

Astle S, Banschbach SK, Briggs WT, Durkin WT, Groah LK, Guglielmi C, et al. Development of consensus statement on defintions for consistent emergency department metrics. J Emerg Nurs. 2012; 38(3):270–2.

Hing E, Bhuiya F. Wait time for treatment in hospital emergency departments: 2009. NCHS Data Brief. 2012;(102):1–8

Bernstein SL, Aronsky D, Duseja R, Epstein S, Handel D, Hwang U, et al. The effect of emergency department crowding on clinically oriented outcomes. Acad Emerg Med. 2009;16(1):1–10.

Ay D, Akkas M, Sivri B. Patient population and factors determining length of stay in adult ED of a Turkish University Medical Center. Am J Emerg Med. 2010;28(3):325–30.

Shi P, Dai J, Ding D, Ang J, Chou M, Jin X, et al. Patient flow from emergency department to inpatient wards: empirical observations from a Singaporean Hospital. 2014. [cited 2016 January 14]. Available at SSRN: or

Hughes G. Four hour target for EDs: the UK experience. Emerg Med Australas. 2010;22(5):368–73.

Di Somma S, Paladino L, Vaughan L, Lalle I, Magrini L, Magnanti M. Overcrowding in emergency department: an international issue. Intern Emerg Med. 2015;10(2):171–5.

Affleck A, Parks P, Drummond A, Rowe BH, Ovens HJ. Emergency department overcrowding and access block. CJEM. 2013;15(6):359–84.

Sabriyati WONI, Islam AA, Gaus S. Faktor-faktor yang berhubungan dengan ketepatan waktutanggap penanganan kasus pada response time I di Instalasi Gawat Darurat Bedah dan Non-Bedah RSUP DR. Wahidin Sudirohusodo [dissertation]. Makasar: Universitas Hasanuddin; 2012.

Jayaprakash N, O’Sullivan R, Bey T, Ahmed SS, Lotfipour S. Crowding and delivery of healthcare in emergency departments: the European perspective. West J Emerg Med. 2009;10(4):233–9.

Sun Y, Heng BH, Tay SY, Seow E. Predicting hospital admissions at emergency department triage using routine administrative data. Acad Emerg Med. 2011;18(8):844–50.

James CA, Bourgeois FT, Shannon MW. Association of race/ethnicity with emergency department wait times. Pediatrics. 2005;115(3):e310-5.

Park CY, Lee MA, Epstein AJ. Variation in emergency department wait times for children by race/ethnicity and payment source. Health Serv Res. 2009;44(6):2022–39.

Schull MJ, Kiss A, Szalai JP. The effect of low-complexity patients on emergency department waiting times. Ann Emerg Med. 2007;49(3):257–64, 264.e1.

Bukhari H, Albazli K, Almaslmani S, Attiah A, Bukhary E, Najjar F, et al. Analysis of waiting time in Emergency Department of Al-Noor Specialist Hospital, Makkah, Saudi Arabia. Open Journal of Emergency Medicine. 2014;2(04):67–73.

Goel S, Gupta A, Singh A, Lenka S. Preparations and limitations for prevention of severe acute respiratory syndrome in a tertiary care centre of India. J Hosp Infect. 2007;66(2):142–7.

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