Abstract
Access block affecting the emergency department (ED), also known as boarding in the United States and Canada, can be described as a phenomenon comprising almost all the challenges in the world of modern EDs. We use the analogy of parallel universes to illustrate both the complexity and the severity of the problem. In the world of physics, many attempts have been made to create a mathematical solution that can answer the more basic questions about physical phenomena in the universe. This has been known as ‘Theory of Everything’. Albert Einstein spent 30 years of his life trying to solve this ‘Theory of Everything’, but failed [1].
Highlights
Access block affecting the emergency department (ED), known as boarding in the United States and Canada, can be described as a phenomenon comprising almost all the challenges in the world of modern Emergency Departments (EDs)
The third problem is that access block is frequently associated with bed capacity and there are studies confirming that hospital wards cannot be run at around 100% occupancy for long without considerable risk to patients as a result of delayed admission from the ED [11,12]
If we considered access block as a disease we would be forced to treat only some of the symptoms, but the fundamental condition would remain unaffected [7,10]
Summary
The third problem is that access block is frequently associated with bed capacity and there are studies confirming that hospital wards cannot be run at around 100% occupancy for long without considerable risk to patients as a result of delayed admission from the ED [11,12]. Appropriate, and improved, staffing of EDs, general wards and diagnostic and support services is necessary to ensure prompt, timely and safe care for patients, 24 hours per day, every day [49]. In order to improve the type and success of access block interventions more multilevel studies are needed instead of retrospective or observational/descriptive studies
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