Evaluation of the risk factors associated with emergency department boarding: A retrospective cross-sectional study.
10.1016/j.cjtee.2020.09.002
- Author:
Yousef NOURI
1
;
Changiz GHOLIPOUR
2
;
Javad AGHAZADEH
3
;
Shahriar KHANAHMADI
4
;
Talayeh BEYGZADEH
4
;
Danial NOURI
5
;
Mehryar NAHAEI
6
;
Reza KARIMI
4
;
Elnaz HOSSEINALIPOUR
4
Author Information
1. Department of Emergency, Urmia University of Medical Sciences, Urmia, Iran. Electronic address: yousef.nouri2018@gmail.com.
2. Department of General Surgery, Tabriz University of Medical Science, Tabriz, Iran.
3. Department of Neurosurgery, Urmia University of Medical Sciences, Urmia, Iran.
4. Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.
5. National Organization for Development of Exceptional Talents, Urmia, Iran.
6. Department of General Surgery, Imam Khomeini Medical Center, Urmia University of Medical Sciences, Urmia, Iran.
- Publication Type:Journal Article
- Keywords:
Downstream ward overcrowding;
Emergency department boarding;
Risk factors
- MeSH:
Age Factors;
Chi-Square Distribution;
Cross-Sectional Studies;
Crowding;
Emergency Service, Hospital;
Female;
Hospital Mortality;
Hospitalization/statistics & numerical data*;
Humans;
Iran;
Length of Stay;
Male;
Patient Admission;
Retrospective Studies;
Risk Assessment/methods*;
Risk Factors;
Sex Factors;
Time Factors;
Triage
- From:
Chinese Journal of Traumatology
2020;23(6):346-350
- CountryChina
- Language:English
-
Abstract:
PURPOSE:Boarding is a common problem in the emergency department (ED) and is associated with poor health care and outcome. Imam Khomeini Hospital is the main healthcare center in Urmia, a metropolis in the northwest of Iran. Due to the overcrowding and high patient load, we aim to characterize the rate, cause and consequence of boarding in the ED of this center.
METHODS:All medical records of patients who presented to the ED of Imam Khomeini Hospital from August 1, 2017 to August 1, 2018 were retrospectively analyzed. Patients with uncompleted records were excluded. Boarding was defined as the inability to transfer the admitted ED patients to a downstream ward in ≥2 h after the admission order. Demographic data, boarding rate, mortality and triage levels (1-5) assessed by emergency severity index were collected and analyzed. The first present time of patients was classified into 4 ranges as 0:00-5:59, 6:00-11:59, 12:00-17:59 and 18:00-23:59. Descriptive, parametric and non-parametric statistical tests were performed and the risk of boarding was determined by Pearson Chi-square test.
RESULTS:Demographic data analysis showed that 941 (58.5%) male and 667 (41.5%) female, altogether 1608 patients were included in this study. Five patients (0.3%) died. The distribution of patients with the triage levels 1-5 was respectively 79 (4.9%), 1150 (71.5%), 374 (23.3%), 4 (0.2%) and 0 (0%). Most patients were of level 2. Only 75 (4.7%) patients required intensive care. The majority of patients (84.2%) were presented at weekdays. The maximum patient load was observed between 12:00-17:59. Of the 1608 patients, 340 (21.1%) experienced boarding within a mean admission time of 13.70 h. Among the 340-boarded patients, 20.1% belonged to surgery, 12.1% to orthopedics, 10.9% to neurosurgery and 10.3% to neurology. The boarding rate was higher in females, patients requiring intensive care and those with low triage levels. Compared with the non-boarded, the boarded patients had a higher mean age.
CONCLUSION:The boarding rate is higher in the older and female patients. Moreover, boarding is dependent on the downstream ward sections: patients requiring surgical management experience the maximum boarding rate.
