Emergency Department (ED) crowding continues to be a pervasive national problem, with
myriad and intransigent negative effects on care efficiency, quality, and cost [
1
,
- Institute of Medicine
- Committee on the Future of Emergency Care in the United States Health System
Hospital-based emergency care: at the breaking point.
http://www.iom.edu
Date: 2006
2
,
3
,
4
,
- Diercks D.B.
- Roe M.T.
- Chen A.Y.
- et al.
Prolonged emergency department stays of non-ST-segment elevation myocardial infarction
patients are associated with worse adherence to the American College of Cardiology/American
Heart Association guidelines for management and increased adverse events.
Ann Emerg Med. 2007; 50: 489-496
5
,
6
,
7
,
8
,
9
,
10
,
]. Furthermore, this demand-capacity mismatch is often due to hospital capacity constraints,
manifested as prolonged patient ED length-of-stay (LOS) while awaiting inpatient admission
[
[12]
,
[13]
]. Termed “ED inpatient boarding”, patients often spend many hours awaiting an inpatient
bed, and frequently undergo additional testing and treatment during that time [
[14]
]. As an important example, radiology testing is a frequently utilized process, highly
subject to capacity constraint, and with significant effects on ED patient throughput
[
15
,
15
,
16
,
17
,
18
,
19
]. Given a large subset of admitted inpatients receive ED imaging, we sought to quantify
radiology utilization in boarding inpatients in our ED.Keywords
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References
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- Quick Stats: Annual Percentage of Emergency Department Visits With Selected Imaging Tests Ordered or Provided — National Hospital Ambulatory Medical Care Survey, United States, 2001–2010.2013: 455 (Available from:)
- Models for improving patient throughput and waiting at hospital emergency departments.J Emerg Med. 2012; 43: 1119-1126
- Decreasing lab turnaround time improves emergency department throughput and decreases emergency medical services diversion: a simulation model.Acad Emerg Med. 2008; 15: 1130-1135
- Applying lean methodologies reduces ED laboratory turnaround times.Am J Emerg Med. 2015; 33 ([PMID: 26145581]): 1572-1576
- The Improvement Guide: A Practical Approach to Enhancing Organizational Performance.2nd ed. Jossey-Bass, San Francisco2009: 36-37
- Describing wait time bottlenecks for ED patients undergoing head CT.Am J Emerg Med. 2017; 35 ([PMID: 28487098]): 1510-1513
- Boarding inpatients in the emergency department increases discharged patient length of stay.J Emerg Med. 2013; 44 ([PMID: 22766404]): 230-235
Article Info
Publication History
Published online: April 07, 2018
Accepted:
April 6,
2018
Received:
April 5,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
