Evaluation of the risk factors associated with emergency department boarding: A retrospective cross-sectional study
| Autor: | Javad Aghazadeh, Mehryar Nahaei, Reza Karimi, Danial Nouri, Talayeh Beygzadeh, Elnaz Hosseinalipour, Yousef Nouri, Changiz Gholipour, Shahriar Khanahmadi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Cross-sectional study Iran Risk Assessment 03 medical and health sciences Patient Admission Sex Factors 0302 clinical medicine Patient Load Intensive care Humans Medicine Orthopedics and Sports Medicine Hospital Mortality Retrospective Studies Emergency department boarding Downstream ward overcrowding 030222 orthopedics lcsh:R5-920 Chi-Square Distribution business.industry Medical record Age Factors 030208 emergency & critical care medicine Overcrowding Emergency department Length of Stay Triage Emergency Severity Index Hospitalization Cross-Sectional Studies Crowding Risk factors Emergency medicine Female Original Article Surgery Emergency Service Hospital business lcsh:Medicine (General) |
| Zdroj: | Chinese Journal of Traumatology, Vol 23, Iss 6, Pp 346-350 (2020) Chinese Journal of Traumatology |
| ISSN: | 1008-1275 |
| Popis: | Purpose Boarding is a common problem in the emergency department (ED) and is associated with poor health care and outcome. Imam Khomeini Hospital is the main healthcare center in Urmia, a metropolis in the northwest of Iran. Due to the overcrowding and high patient load, we aim to characterize the rate, cause and consequence of boarding in the ED of this center. Methods All medical records of patients who presented to the ED of Imam Khomeini Hospital from August 1, 2017 to August 1, 2018 were retrospectively analyzed. Patients with uncompleted records were excluded. Boarding was defined as the inability to transfer the admitted ED patients to a downstream ward in ≥2 h after the admission order. Demographic data, boarding rate, mortality and triage levels (1–5) assessed by emergency severity index were collected and analyzed. The first present time of patients was classified into 4 ranges as 0:00–5:59, 6:00–11:59, 12:00–17:59 and 18:00–23:59. Descriptive, parametric and non-parametric statistical tests were performed and the risk of boarding was determined by Pearson Chi-square test. Results Demographic data analysis showed that 941 (58.5%) male and 667 (41.5%) female, altogether 1608 patients were included in this study. Five patients (0.3%) died. The distribution of patients with the triage levels 1–5 was respectively 79 (4.9%), 1150 (71.5%), 374 (23.3%), 4 (0.2%) and 0 (0%). Most patients were of level 2. Only 75 (4.7%) patients required intensive care. The majority of patients (84.2%) were presented at weekdays. The maximum patient load was observed between 12:00–17:59. Of the 1608 patients, 340 (21.1%) experienced boarding within a mean admission time of 13.70 h. Among the 340-boarded patients, 20.1% belonged to surgery, 12.1% to orthopedics, 10.9% to neurosurgery and 10.3% to neurology. The boarding rate was higher in females, patients requiring intensive care and those with low triage levels. Compared with the non-boarded, the boarded patients had a higher mean age. Conclusion The boarding rate is higher in the older and female patients. Moreover, boarding is dependent on the downstream ward sections: patients requiring surgical management experience the maximum boarding rate. |
| Databáze: | OpenAIRE |
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