Graduation Semester and Year
Fall 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Dr. Kirsten Drake
Abstract
Introduction: Patients who leave the emergency department before evaluation may experience delayed care and contribute to quality and safety concerns. At the project site, the baseline left without being seen rate was 7%. This quality-improvement project evaluated whether a risk-identification tool linked to rapid provider evaluation could improve care for patients at increased risk of leaving before evaluation.
Methods: The project was implemented over eight weeks in a large urban community emergency department. Adults presenting as walk-in patients were screened using a left without being seen risk-identification tool. Patients with a risk score of 3 or greater were classified as high risk, the charge nurse was notified, and rapid provider evaluation was initiated. Demographic, clinical, process, and outcome data were collected and analyzed descriptively.
Results: A total of 1,198 high-risk patients were included in the final project database. Charge nurse notification was completed for all high-risk patients, and rapid provider evaluation was completed for 99.8%. Six patients left without being seen, corresponding to a rate of 0.50% within the high-risk intervention cohort, which was below the project target of 2%.
Conclusion: Linking early risk identification with rapid provider evaluation was feasible within an existing emergency department workflow and may offer a practical approach for reducing the likelihood that high-risk patients leave before evaluation. Continued monitoring, staff reinforcement, and future electronic health record integration may support longer-term sustainability.
Keywords
Emergency Service, Hospital; Quality Improvement; Patient Dropouts; Triage; Time-to-Treatment; Patient Safety
Disciplines
Other Nursing
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Slatten, Jeremiah W., "Reducing Left Without Being Seen Rates Through Risk Identification and Rapid Provider Evaluation" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 30.
https://mavmatrix.uta.edu/nursing_dnpprojects2/30