Hospitals underutilize tools to reduce boarding, which results in crowded emergency departments and subpar patient care, according to an analysis in Health Affairs.
Boarding is the practice of keeping admitted patients on stretchers in hospital ED hallways for hours or days, according to the report. Boarding causes ED crowding and can hamper quality patient care. However, strategies to reduce this practice are not widely used, according to the report.
The author offers the following nine strategies to reduce boarding and ED crowding by increasing efficiency:
1. Moving boarders to inpatient halls. Moving patients to less crowded inpatient halls frees up ED beds and may facilitate placement into inpatient rooms.
2. Smoothing elective surgical and catheterization schedules. Scheduling procedures evenly over the week can avoid sharp increases in demand for inpatient beds.
3. Scheduling early cardiac catheterizations. Scheduling cardiac catheterizations early in the day can "expedite the freeing of unneeded beds reserved for postcatheterization patients," according to the report.
4. Active bed management. Assigning a staff member or using computerized systems to track bed use enables the hospital to address bottlenecks quickly.
5. Discharge lounge. Moving patients awaiting discharge who no longer need a bed to a lounge can free up inpatient beds.
6. Aggressive management and expediting of inpatient discharges. Beginning discharge planning at the time of admission helps ensure post-discharge plans are established, which can speed the discharge process.
7. Monitoring of bed-cleaning turnaround time. Monitoring bed-cleaning turnaround time increases accountability and can improve patient flow.
8. Simplified admission protocol. Streamlining processes for transferring patients between the ED and inpatient areas can improve flow.
9. "Reverse triage." During disasters, hospitals can identify and discharge patients with the least need for inpatient beds to accommodate patients who need beds.
Aroostook Medical Center in Maine Reduces Patients' Total Time in ED by 15%
Riddle Hospital in Pennsylvania Opens Rapid Evaluation Unit to Improve ED Patient Flow
Boarding is the practice of keeping admitted patients on stretchers in hospital ED hallways for hours or days, according to the report. Boarding causes ED crowding and can hamper quality patient care. However, strategies to reduce this practice are not widely used, according to the report.
The author offers the following nine strategies to reduce boarding and ED crowding by increasing efficiency:
1. Moving boarders to inpatient halls. Moving patients to less crowded inpatient halls frees up ED beds and may facilitate placement into inpatient rooms.
2. Smoothing elective surgical and catheterization schedules. Scheduling procedures evenly over the week can avoid sharp increases in demand for inpatient beds.
3. Scheduling early cardiac catheterizations. Scheduling cardiac catheterizations early in the day can "expedite the freeing of unneeded beds reserved for postcatheterization patients," according to the report.
4. Active bed management. Assigning a staff member or using computerized systems to track bed use enables the hospital to address bottlenecks quickly.
5. Discharge lounge. Moving patients awaiting discharge who no longer need a bed to a lounge can free up inpatient beds.
6. Aggressive management and expediting of inpatient discharges. Beginning discharge planning at the time of admission helps ensure post-discharge plans are established, which can speed the discharge process.
7. Monitoring of bed-cleaning turnaround time. Monitoring bed-cleaning turnaround time increases accountability and can improve patient flow.
8. Simplified admission protocol. Streamlining processes for transferring patients between the ED and inpatient areas can improve flow.
9. "Reverse triage." During disasters, hospitals can identify and discharge patients with the least need for inpatient beds to accommodate patients who need beds.
More Articles on Capacity Management:
Study: Hospitals Serving More Minority Patients May Have More Crowded EDsAroostook Medical Center in Maine Reduces Patients' Total Time in ED by 15%
Riddle Hospital in Pennsylvania Opens Rapid Evaluation Unit to Improve ED Patient Flow