Evaluation of the Abandonment Rate for the Optimization of Emergency Department Pathways: The Case of the Peninsular Territory of the A.S.L. Napoli 3 Sud

For years, the Emergency Department (ED) has been struggling to meet a demand that is only increasing more quickly than it can handle. Patients are pushed to leave the ED by this condition, which is made worse by congestion. Furthermore, to being risky for subjects who lose contact with the systems of care as a result, the phenomenon known as “left without being seen” (LWBS) may further be utilized as a quality measure for performance assessment. This study examined, also through the use of the DMAIC cycle of the Lean Six Sigma methodology, the LWBS rate for 2021 at the Emergency Department of ASL Naples 3 South in Italy. Firth logistic regression and statistical analysis were applied to achieve this. The two determined categories were then examined using statistical analysis and logistic regression after the dataset had been created. According to the findings, patients who approach the ED in the evening and who have non-critical conditions are more likely to leave the facility. Patients who leave the emergency department (ED) in particular tend to be younger on average, have a White or Green code, and arrive on their own between 12:00 and 24:00. Thinking for both groups, the average ED-LOS wait time is 180 min. Value: The objective is to determine whether or not the recognized and easily accessible risk factors serve as predictors of ED exit behaviour. To this end and thanks to the DMAIC cycle, the entire activity of the Emergency Department of the ASL Naples 3 South (Italy) has been processing for the year 2021.