News | May 10, 2007

ED Patients Who Must “Board” While Waiting for Inpatient Beds Prefer Inpatient Hallways

May 11, 2007 - 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 (“Emergency department patient preferences for boarding locations when hospitals are at full capacity”).

“Boarding is never the preference of emergency physicians or their patients, but this study clearly shows that patients who must board prefer to get out of the emergency department and into inpatient hallways,” said study author Jesse Pines, M.D. of the Hospital of the University of Pennsylvania in Philadelphia. “In addition to raising patient satisfaction, transferring admitted patients out of the emergency department reduces crowding and gridlock, two of the most pernicious problems in emergency departments across the country.”

The study, conducted over a four-week period at an urban teaching hospital, surveyed 431 admitted patients. Of those who expressed a preference for boarding location (64 percent 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 just over 12 hours.

“There are many rationales for rapid patient transfer out of the emergency department for admitted patients,” said Dr. Pines. “Boarding admitted patients on inpatient hallways may reduce emergency department crowding, locate patients geographically closer to their inpatient physician, and allow the patient’s plan of care to be implemented more rapidly and effectively. This study provides another good reason to transfer admitted patients out of the emergency department: patient preference.”

The study complements recommendations made by the American College of Emergency Physicians and the Institute of Medicine with regard to the practice of boarding. While some hospitals board patients admitted from the emergency department on inpatient hallways, most do not. Boarding in inpatient hallways has been deemed acceptable by the New York Department of Health, but hospitals have been slow to adopt the practice.

“High levels of emergency department boarding reduce the ability of emergency departments to treat new patients and compromise the quality of care,” said Dr. Pines. “Now we know that it is undesirable also in the eyes of our patients.”

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