Emergency Room Boarding
Running head: BOARDING PATIENTS IN THE EMERGENCY DEPARTMENT 1
Boarding Patients in the Emergency Department
Lauren Wiese
University of Scranton
BOARDING PATIENTS IN THE EMERGENCY DEPARTMENT 2
Abstract
A patient who is boarded is one who remains in the emergency department even after they have been admitted to the hospital. Boarding patients in the emergency department has become a problem for many hospitals in America today. It has affected the health and safety of patients and staff in numerous ways. This is an issue that needs to be resolved soon or the overall quality of healthcare in America will drop substantially.
BOARDING PATIENTS IN THE EMERGENCY DEPARTMENT 3
Boarding Patients in the Emergency Department A major issue affecting hospitals in the United States today is the process of boarding patients in the emergency department (ED). It is the primary cause of overcrowding in a hospital and affects more than 90% of hospitals in America (Lowes, 2001). The practice of boarding or “holding” patients endangers the safety of hospital staff and the patients themselves. It causes delays in care and even worse ambulance diversions. Emergency department visits climbed fourteen percent from 1992 to 1999 (Lowes, 2001). This shows that boarding patients is a risk to the incoming ED patients. The nursing shortage in America is a direct contributor to the practice of holding patients in the ED. When there are beds available for patients in the hospital, there might not be personnel to staff them (Lowes, 2001). There have been instances where there were unoccupied inpatient beds but just no nurses to care for them. In some parts of the country, the scarcity of nurses has reached crisis proportions. Another cause for the use of boarding patients is hospital downsizing, which instantly affects the amount of inpatient rooms. The latter part of the twentieth century experienced major hospital closings and ED closings.
Boarding Patients in the Emergency Department
Lauren Wiese
University of Scranton
BOARDING PATIENTS IN THE EMERGENCY DEPARTMENT 2
Abstract
A patient who is boarded is one who remains in the emergency department even after they have been admitted to the hospital. Boarding patients in the emergency department has become a problem for many hospitals in America today. It has affected the health and safety of patients and staff in numerous ways. This is an issue that needs to be resolved soon or the overall quality of healthcare in America will drop substantially.
BOARDING PATIENTS IN THE EMERGENCY DEPARTMENT 3
Boarding Patients in the Emergency Department A major issue affecting hospitals in the United States today is the process of boarding patients in the emergency department (ED). It is the primary cause of overcrowding in a hospital and affects more than 90% of hospitals in America (Lowes, 2001). The practice of boarding or “holding” patients endangers the safety of hospital staff and the patients themselves. It causes delays in care and even worse ambulance diversions. Emergency department visits climbed fourteen percent from 1992 to 1999 (Lowes, 2001). This shows that boarding patients is a risk to the incoming ED patients. The nursing shortage in America is a direct contributor to the practice of holding patients in the ED. When there are beds available for patients in the hospital, there might not be personnel to staff them (Lowes, 2001). There have been instances where there were unoccupied inpatient beds but just no nurses to care for them. In some parts of the country, the scarcity of nurses has reached crisis proportions. Another cause for the use of boarding patients is hospital downsizing, which instantly affects the amount of inpatient rooms. The latter part of the twentieth century experienced major hospital closings and ED closings.
References: Cowan, R.M. (2005). Clinical Review: Emergency department overcrowding and the potential impact on the critically ill. Crit Care; 9(3), 291-295. Derlet, R.W. (1995). Prospective identification and triage of nonemergency patients out of an emergency department: A 5-year study. Annals of Emerg Med; 25:215-223. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672221/pdf/wjem-9- 0024.pdf Krochmal, P. (1994). Increased health care costs associated with ED overcrowding. Am J Emerg Med; 12(3), 265-266. Lowes, R. (2001). What will it take to solve the ER crisis? Medical Economics, 78(23), 70-2, 77, 81. Retrieved from http://search.proquest.com/docview/227782380?accountid=28588 Pines J.M. (2006). The association between emergency department crowding and hospital performance. Acad Emerg Med; 13(8), 873-878. Richardson, D.B. (2006). Increase in patient mortality at 10 days associated with ED overcrowding. Med J Aust; 184(5), 213-216. Schull, M.J. (2003). Emergency department contributors to ambulance diversion: a quantitative analysis. Annals of Emerg Med. 41(4), 467-476.