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Patient Preferences on Boarding

Patient Preferences on Boarding

Crowding in the ED has been well-established as a problem that poses a threat to public health. Studies show that ED and hospital crowding leads to ambulance diversions, medical errors, delayed care, and increased mortality rates. “Many strategies have been tried to alleviate ED and hospital crowding, some of which involve the entire institution,” explains Peter Viccellio, MD. Using a Full-Capacity Protocol One strategy that aims to reduce ED crowding is the use of a full-capacity protocol (FCP), in which admitted ED patients are redistributed to inpatient unit hallways while they wait for regular hospital beds to open up. Some studies have shown that an FCP can decrease ED wait times, ambulance diversions, and overall hospital length of stay. A potential concern with this approach, however, is that it could reduce patient satisfaction. Recently, Dr. Viccellio and colleagues had a study published in the Journal of Emergency Medicine that examined patient preference and satisfaction with boarding in the ED versus inpatient hallways during times when there were no inpatient beds available for admitted patients. All patients were initially boarded in the ED in a hallway before their transfer to an inpatient hallway bed. “No more than two patients in our study were placed on any inpatient unit and all patients received direct care from inpatient physicians and nurse specialists,” adds Dr. Viccellio. “We didn’t compare a room versus a hallway. Rather, we looked at making decisions about where patients can receive the best care and greatest attention in difficult circumstances when a normal room is not available.” Overwhelming Results According to the results, the overall preferred location after admission...
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