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Text
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URL Address
<a href="http://doi.org/10.1002/emp2.12100" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/emp2.12100</a>
Pages
1052-1059
Issue
5
Volume
1
ISSN
2688-1152 2688-1152
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Update Year & Number
December 2020 List
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Cleveland Clinic Akron General Hospital
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Title
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The impact of hospital boarding on the emergency department waiting room.
Publisher
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Journal Of The American College Of Emergency Physicians Open
Date
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2020
2020-10
Subject
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length of stay; crowding; emergency department boarding; emergency department wait times; hospital occupancy; waiting room
Creator
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Smalley CM; Simon EL; Meldon SW; Muir McKinsey R; Briskin I; Crane S; Delgado F; Borden BL; Fertel BS
Description
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BACKGROUND: Patient boarding in the emergency department (ED) is a significant issue leading to increased morbidity/mortality, longer lengths of stay, and higher hospital costs. We examined the impact of boarding patients on the ED waiting room. Additionally, we determined whether facility type, patient acuity, time of day, or hospital occupancy impacted waiting rooms in 18 EDs across a large healthcare system. METHODS: This was a retrospective multicenter study that included all ED encounters between January 1, 2018, and September 30, 2019. Encounters with missing Emergency Severity Index (ESI) level were excluded. ESI levels were defined as high (ESI 1,2), middle (ESI 3), and low (ESI 4,5). Spearman correlation coefficients measured the relationship between boarded patients and number of patients in ED waiting room. A multivariable mixed effects model identified drivers of this relationship. RESULTS: A total of 1,134,178 encounters were included. Spearman correlation coefficient was significant between number of patients in the ED waiting room and patient boarding (0.54). For every additional patient boarded/hour, the number of patients waiting/hour in the waiting room increased by 8% (95% confidence interval [CI] = 1.08-1.09). The number of patients waiting for a room/hour was 2.28 times higher for middle than for high acuity. The number of patients in waiting room slightly decreased as hospital occupancy increased (95% CI = 0.997-0.997). CONCLUSION: Number of patients in ED waiting room are directly related to boarding times and hospital occupancy. ED waiting room times should be considered as not just an ED operational issue, but an aspect of hospital throughput.
Identifier
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<a href="http://doi.org/10.1002/emp2.12100" target="_blank" rel="noreferrer noopener">10.1002/emp2.12100</a>
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journalArticle
2020
Borden BL
Briskin I
Cleveland Clinic Akron General Hospital
Crane S
Crowding
December 2020 List
Delgado F
Department of Emergency Medicine
emergency department boarding
emergency department wait times
Fertel BS
hospital occupancy
Journal Of The American College Of Emergency Physicians Open
journalArticle
Length of Stay
Meldon SW
Muir McKinsey R
NEOMED College of Medicine
Simon EL
Smalley CM
waiting room