Reduce Left-Without-Being-Seen (LWBS) Rates Through Better Triage

Left-Without-Being-Seen (LWBS) — when patients leave the emergency department (ED) before receiving clinical evaluation — is more than a frustrating metric. It reflects operational inefficiencies, risks patient safety, and diminishes both revenue and reputation for healthcare systems. With ED volumes rising post-pandemic and staffing shortages ongoing, effective triage strategies have never been more critical.

In this article, we explore why it matters, the clinical and financial impact of high LWBS rates, and how data-backed triage improvements can dramatically reduce LWBS across healthcare systems.

Why LWBS Matters: Clinical, Operational & Financial Impacts

📊 Patient Safety & Clinical Outcomes

High LWBS rates correlate with poorer patient outcomes, especially when the reason for leaving is prolonged wait times rather than symptom resolution. Patients who leave before care may return with worsened conditions or complications — outcomes that could have been prevented with timely evaluation.

📉 Operational Strain

Objectives like door-to-provider time and ED throughput are core determinants of LHBS rates. Analysis shows that longer wait times for triage and boarding areas directly increase LWBS likelihood.

💸 Financial Consequences

Every patient who leaves without being seen represents lost revenue for the health system. Case studies estimate millions in lost charges when LWBS rates are elevated — with one community hospital reducing LWBS from 6.3% to 1.2%, recouping an estimated $1 million annually in revenue.

Key Data on LWBS Trends

📌 National Benchmarks: Historical data demonstrated an average LWBS rate of ~1.7% in EDs across the U.S. — with rates rising in recent years due to increased volumes and resource challenges.

📌 Impact of Triage Delays: Research identifies door-to-triage time, triage-to-bed time, and boarding delays as top contributors to LWBS risk. Addressing these factors can reduce LWBS rates by up to ~60%.

How to Reduce LWBS Rates Through Better Triage

Reducing Left-Without-Being-Seen (LWBS) starts with optimizing the triage process. The faster and more accurately patients are assessed upon arrival, the less likely they are to leave before receiving care. Key strategies include:

• Early Clinical Assessment: Placing a clinician at triage or implementing a rapid intake process ensures patients are engaged quickly.

• Prioritization Based on Acuity: Identifying high-risk patients early prevents delays that can lead to LWBS.

• Streamlined Workflow: Reducing bottlenecks from check-in to treatment areas improves patient flow and shortens perceived wait times.

• Patient Communication: Keeping patients informed about expected wait times and next steps reduces frustration and abandonment.

AI-Powered Triage: The Next Level of Efficiency

AI is transforming triage from a reactive process into a proactive, data-driven system. By analyzing real-time patient data and historical trends, AI can help predict patient acuity, optimize routing, and anticipate bottlenecks — ensuring patients are seen promptly and safely.

Innovations like ambient listening, help capture patient interactions automatically, reducing the documentation burden on nurses and minimizing errors. This means clinicians can focus on patient care instead of data entry, while key clinical information is accurately recorded.

AI also helps reduce patient misroutes by identifying the most appropriate care pathway early in the visit. This means fewer unnecessary transfers between units, faster clinical decisions, and shorter wait times — all contributing to lower LWBS rates.

Solutions like the triage decision support tool from Trendlytics leverage AI-driven insights and ambient data capture to streamline triage, reduce errors, and ensure patients are seen promptly — lowering LWBS while boosting both clinical outcomes and operational efficiency. Learn More.