Boarded ED Patients Prefer In-Patient Hallways
A new study of emergency patient preferences for boarding locations shows that admitted patients prefer to board out of the emergency department and in inpatient hallways by a margin of three to two. The study appears online in the Annals of Emergency Medicine. Researchers at the Hospital of the University of Pennsylvania in Philadelphia surveyed 431 admitted patients over four weeks. Of those who expressed a preference for boarding location (64% of the total), 59 percent preferred inpatient hallways and 41 percent preferred emergency department hallways. During the study period, the median weekly emergency department boarding time ranged from eight and a half hours to a little more than 12 hours.
ED Expansion: No Quick Fix
ED expansion won't improve ambulance diversion unless other bottlenecks in the hospital are addressed, according to a study in Academic Emergency Medicine. (2007;14:338.) Increasing ED bed capacity did not affect ambulance diversion, but did increase total and admission hold length of stay.
Investigators in the departments of emergency medicine, biostatistics, anesthesiology, and biomedical informatics at Vanderbilt University Medical Center in Nashville, TN, looked at the effect of expanding an urban, academic Level I trauma center from 28 to 53 beds. Using data from five months before and five months after the expansion as well as ED and waiting room statistics and diversion status, they found no significant change in the time spent on ambulance diversion per month. The expansion did result in increased daily patient volume, however, while ED occupancy decreased. Mean length of stay increased from 4.6 hours to 5.6 hours, and mean admission hold length of stay rose 3.0 hours to 4.1 hours.
The proportion of patients who left without being seen was 3.5 percent and 2.7 percent in the pre-expansion and postexpansion periods, respectively.