Beyond business hours: Patient arrival patterns at burn centers

• A higher frequency of patients arrive at a burn center after hours. • Clinical outcomes are not well defined for patients presenting after hours. • Patient presentation times affect hospital operations and workflow. Burn patients can present to a medical facility at any given time. By their nature, one cannot predict when a burn injury will occur. Anecdotal accounts suggest that most burn patients present after “business hours,” however, limited objective data exists on presentation patterns of burn injury. Retrospective arrival times of all patients presenting to the emergency room at two different burn centers in different states were collected over a 1-year period to determine total number of patients arriving during business hours vs. after hours. Business hours were defined as 8:00AM–4:00PM. A secondary time window of extended business hours by an additional 2 h (8:00AM–6:00015PM) was also assessed. Over the course of 1 year, 712 patients were identified at both centers and 63.5 % of all patients presented after normal business hours (p = 0.029). When business hours were extended by 2 h, 51.1 % of patients still presented after hours (p = 0.041). This study suggests most patients do not present to a burn center during normal hours. The implications of this on patient outcomes, quality of care, and research warrant further investigation.