Background: Increased Emergency Department (ED) boarding has been linked to worse patient outcomes, including delays in treatment (Jiraporn et al 2014), increased length of stay (Singer et al 2011), and increased mortality (Singer et al 2011; Sun et al 2013). Patients who meet time zero (T-0) for diagnosis with severe sepsis while boarding in the [...]

Background: Emergency Department (ED) overcrowding and delays in ED throughput have several important consequences , such as boarding of admitted patients in the ED, longer hospital stays and delay in effective inpatient discharge planning (1). Longer ED boarding time and delay in inpatient discharge process are parts of a vicious cycle of internal bottleneck contributing [...]

Background: Emergency department (ED) overcrowding is associated with a range of negative outcomes, including increased patient morbidity, decreased patient satisfaction, provider burnout, and violence against providers. ED boarding of admitted patients coupled with increasing ED patient volumes contributes to overcrowding. Geographic localization, where hospitalist provider teams are assigned patients on the same inpatient unit, has [...]

Background: Emergency Department (ED) boarding, which occurs when admitted patients do not have an available bed in the hospital, has been associated with adverse patient outcomes. In 2014, 13,109 patients waited greater than 2 hours for a medicine inpatient bed at our large urban academic center. In July 2016, we deployed a 24-hour hospital medicine [...]

Background: Emergency department (ED) overcrowding is a commonly encountered challenge and is associated with adverse events and poor patient satisfaction.  One of the factors that can contribute to ED overcrowding is the boarding of admitted patients in the ED. Various methods have been implemented to improve this issue with limited success.     Purpose: A collaborative workgroup [...]

Background: Boarding of admitted patients in the Emergency Department has become an increasingly large problem throughout the country. Longer boarding times are associated with a wide range of adverse effects, ranging from patient discomfort to medical errors and death. Emergency Departments are not designed to provide inpatient care and require frequent diversion of attention and [...]

Background: Geographic localization is the practice of assigning physician and advanced practice provider teams to patients located in the same inpatient unit. Poor localization of hospital medicine teams at our institution was identified as a top cause of increased Emergency Department boarding and Length Of Stay (LOS). The purpose of our process improvement project is [...]