The Impact of Immediate Bedding on Throughput in the Emergency Department

Autor: James, Scott Eugene
Jazyk: angličtina
Rok vydání: 2019
Předmět:
DOI: 10.17918/00000063
Popis: Patient overcrowding in emergency departments (ED) is a problem that leads to extended wait times, higher left-without-being-seen rates (LWBS), and increased morbidity and mortality of patients. Numerous strategies to reduce door-to-provider time (DTP) are represented in the literature and have proven effective in lowering LWBS rates thus, also reducing patient morbidity and mortality. This project focused on one such strategy, immediate bedding, in which patients were expeditiously placed in an ED treatment space to begin care. An immediate bedding intervention was implemented between the hours of 06:00 a.m. and 11:00 a.m. for 7 consecutive days in a high volume, urban, academic medical center. LWBS rates and door-to-bed times during the intervention period were compared to LWBS rates and door-to-bed times during a similar 7-day control period that did not offer an intentional immediate bedding intervention. Numerous challenges and barriers were discovered during the project. Of the patients who were immediately bedded (N=28) during the intervention period, none of them LWBS. Of the patients who were immediately bedded during the control period (N=20), 5% LWBS. Door-to-bed times were lower in the intervention group with 48% of patients bedded within 30 minutes of arrival compared to 39% of patients in the control group. Statistical analysis of LWBS outcomes showed no evidence of significance between the independent groups using a chi-squared test. These results cannot be applied to all high volume, urban, academic medical center EDs and additional study is needed to more fully understand the operational limitations to immediate bedding that were encountered during the project.
Keywords: emergency department, overcrowding, left-without-being-seen, immediate bedding, pull-until-full, triage
Databáze: OpenAIRE
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