1. Do admitted patients held in the emergency department impact the throughput of treat-and-release patients?
- Author
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Bazarian JJ, Schneider SM, Newman VJ, and Chodosh J
- Subjects
- Adult, Anemia, Sickle Cell therapy, Asthma therapy, Chest Pain therapy, Emergency Service, Hospital organization & administration, Health Services Research, Hospital Bed Capacity, 500 and over, Hospital Units organization & administration, Hospitals, Teaching, Humans, New York, Retrospective Studies, Seizures therapy, Time Factors, Time Management, Emergency Service, Hospital statistics & numerical data, Hospital Units statistics & numerical data, Patient Admission standards, Waiting Lists
- Abstract
Objective: To examine the impact of reducing ED "boarders" (through the use of a short-stay inpatient medicine unit) on the amount of time that treat-and-release patients spend in the ED., Methods: A retrospective analysis of hours spent in the ED was made at a university hospital teaching ED for treat-and-release patients in 4 clinical categories: chest pain, asthma exacerbation, sickle-cell crisis, and seizure. The average hours per patient spent in the ED during the 4-month intervals before (August-November 1993) and after (August-November 1994) the establishment of the short-stay medicine unit were compared. Data were analyzed using the 2-tailed, unpaired t-test., Results: This short-stay inpatient medicine unit received on average 135 patients per month from the ED, with an average length of stay of 2.4 days. The mean (+/-SD) number of admitted patients per day waiting in the ED > 8 hours for an inpatient bed dropped from 9.6 +/- 4.2., before the institution of this unit, to 2.3 +/- 2.6. There was a significant reduction in the average number of hours spent in the ED by treat-and-release patients with chest pain (from 7.3 +/- 6.0 to 5.5 +/- 4.8 hr/patient, p < 0.001) and asthma exacerbation (from 5.0 +/- 3.6 to 4.2 +/- 2.9 hr/patient, p < 0.05), but not with sickle-cell crisis or seizure, after the implementation of the short-stay unit., Conclusion: Reducing the number of admitted patients waiting in the ED for inpatients beds, in this case by establishment of a short-stay medicine unit, is associated with a decrease in the interval that treat-and-release patients spend in the ED.
- Published
- 1996
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