Hospitals ease ER crowding with beds in halls

[ERDoc]

I Love ERDocs ideas statiscal based medicine the concept applied in utilization, and bed management (hey ERDoc want a job up here, we have great beef and beers eh!

I'll let you know on Nov 5th about that job.

[Richard B the EMT]

To me, it matters not if the patient is held in the ER or an upstairs hallway, it is still "boarding".

Could it be my imagination that when patient populations go up, hospital management grows scarce, but when the patient population goes down, you cannot get away from the management?

A mention: I was hallway boarded for 2 days in 1967, and recovery room boarded for 2 days in 2007 (specifics as to why I was in the hospital won't appear here!).

[ERDoc]

Richard, you can call it what you want but the idea is to decrease the length of stay in the ER, which opens up more ER beds to see the next patient. This will directly affect EMS by having more available beds to transfer your patient to.

[tniuqs]

(specifics as to why I was in the hospital won't appear here!).

:oops: Just a guess Piles ? :twisted:

[Richard B the EMT]

Are you trying to violate the HIPAA rules?

[WolfmanHarris]

It seems that by shifting the patient's being boarded to the unit they'll be eventually staying in the problem of bed shortage becomes a small problem for one department not an overwhelming problem for the ED. Imagine CCU having two patient's in their hall, being seen by their staff who want to find them a proper bed. They have patient contact, the staff treating them are part of their definitive care rather than the ED while they wait. These staff now have a face to the two beds they have to free up, not just a phone call from downstairs. This seems better than keeping a dozen patients in a crowded ED with the staff there responsible for pushing for space for them. It puts the people who know the needs of their department of what they have to deal with in charge of finding the spots on their unit rather than someone from outside pushing them to accommodate.

[sjslennon]

It seems that by shifting the patient's being boarded to the unit they'll be eventually staying in the problem of bed shortage becomes a small problem for one department not an overwhelming problem for the ED.... This seems better than keeping a dozen patients in a crowded ED with the staff there responsible for pushing for space for them.

This is a beautiful thought. ACEP is pushing for it, so let's see if it really happens.

In my ED, there are days when:

Every bed is full, either with pts waiting for beds upstairs, or waiting for their workup to be complete (and these pts are too sick to sit in the lobby and wait for results).

There is a 4+ hour wait to be seen.

Every nurse is busy with their usual load of sick pts, plus the additional sick pts that we can't get to the wards.

Paramedics line the walls that aren't taken with ED pts, because we have no beds for them to put their pts in, and their pts are too sick to sit in the lobby and wait. They sometimes wait as long as the lobby pts.

Every tech is busy, either supporting the nurses or circulating in the waiting room, rechecking vitals on the crowds waiting to be seen.

And I sit at my desk with NOTHING to do - because I have no space in which to see a new pt.

It is frustrating for all.

[ERDoc]

DocHarris, ICU pts are one type of pt that will not be boarded in the hall on the units. They require too much care and equipment. Putting ICU pts in the hall could be dangerous.

[Richard B the EMT]

It is frustrating for all.

Frustrating as an EMT, a PA, or both? And probably so in any combination.

There was a time 3 decades ago, at least one of my local hospitals had a plan, in the event of a major incident, any in-patient who could be "safely" done so, would have been discharged, opening up a bed. In addition, they would have resorted to the "army stretcher on cafeteria table in cafeteria" plan. Food would not be served (DUH!), but a sizable number of patients, theoretically, could have been seen.

The only time I am aware of that the plan was implemented, was in June of 1975, for the Eastern Airlines Flight 66 crash on Rockaway Blvd, literally on the perimeter fence at John F Kennedy International Airport, Jamaica, Queens County, New York. The hospital figured out how bad the incident was, when no patients were brought in (727 Jet slammed down by a wind shear while on final approach, with 113 souls aboard killed, no ground casualties).

[WolfmanHarris]

DocHarris, ICU pts are one type of pt that will not be boarded in the hall on the units. They require too much care and equipment. Putting ICU pts in the hall could be dangerous.

Fair enough. Went with the first thing that came to mind.