RT Journal Article SR Electronic T1 Difference in time to x ray with similar time to treatment decision leads to differences in waiting times of patients with hip fracture in a crowded emergency department JF Emergency Medicine Journal JO Emerg Med J FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine SP 274 OP 275 DO 10.1136/emj.2007.051490 VO 25 IS 5 A1 W-T Chia A1 Y-S Chen A1 C-F J Lin A1 H-H Liu A1 B-F Lin YR 2008 UL http://emj.bmj.com/content/25/5/274.abstract AB Objective: Crowding of patients is common in emergency departments. The number of hip fracture patients not regarded as urgent builds up and patients wait for treatment. In this paper, we present the causes of waiting time and provide some suggestions to improve patient flow in emergency departments.Methods: We undertook a retrospective review of emergency department records. Included in this study were 112 hip fracture patients seen between January 2005 and January 2007 at an urban, academically affiliated trauma centre. We recorded time to admission, to x ray, and to a definitive treatment decision. Patients were divided into two groups based on time to x ray of ⩽5 min, or >5 min.Results: There was no difference in the time between taking the x ray and the definitive decision on treatment in the two groups.Conclusions: We may reduce total waiting time for hip fracture patients by taking an x ray during triage. There are many patients in crowded emergency departments whose symptoms of hip contusion and hip pain, and with a clear history of a fall, are known at admission. Taking an x ray during triage when a patient presents with a typical history and symptoms can reduce total waiting time. We hope that further evaluation could confirm this point.