An analysis of emergency department-boarded patients awaiting inpatient beds

Abstract

Background: Emergency department (ED) overcrowding and boarding are the most important factors that affect health services and quality of care all over the world. The objective of this study is to evaluate the length of stay of patients boarded in the ED and to analyze patients’ data in respect to the length of stay. Methods: This prospective study was carried out in a one-year period. The study included patients older than 18 years old who stayed in the ED more than 3 hours after the decision to transfer the patient to the relevant department due to unavailability of vacant inpatient beds. The mode of arrival to the ED, demographic features, the length of stay, clinical course, and outcomes were recorded and statistically analyzed. Results: A total of 1750 patients were included in the study. Thirty-five percent of patients stayed more than 24 hours in the ED. Department of Infectious Diseases admitted the highest number of the patients (22.5%). Patients’ need for Intensive Care Unit, departments awaited to admit patients, and patients’ Emergency Severity Index were compared to patients’ length of stay and Charlson Comorbidity Index. Differences between groups were statistically significant (p<0.05). Conclusions: Insufficient number of inpatient beds is a major factor contributing to the ED boarding and overcrowding, which may have various unfavorable effects on both patient safety and functionality of EDs. Multidisciplinary solutions are required to overcome the problem.