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Joint Commission Official: Don't Put Patients in Egress Halls When ED Overcrowds
Those of you who plan to move patients into exit corridors when routine ED overcrowding occurs may want to reconsider that policy given what a Joint Commission official said about the matter.
Patients on gurneys and chairs cannot be parked in egress corridors because of Life Safety Code® requirements for minimum clear widths, said George Mills, FASHE, CEM, CHFM, senior engineer at The Joint Commission.
Even if state regulators order healthcare facilities to get patients out of EDs and instead hold them in inpatient unit corridors, The Joint Commission doesn't believe this is the best approach, Mills said during a recent Joint Commission Resources audio conference.
Instead, such a situation should prompt facility managers and ED directors to review ED traffic flow and come up with better ways to manage overcrowding, he said.
An exception to this stance is a disaster-related influx of patients to a healthcare facility, during which corridor treatment of patients may be the only way to deal with a sudden surge of victims.
An exception: Disaster influxes
The Joint Commission's position has wider backing. The Healthcare Interpretations Task Force—an influential group of authorities that reviews National Fire Protection Association (NFPA) provisions for medical settings—developed an informal policy on the matter that frowns upon staging patients in egress corridors.
The task force's decisions aren't formal NFPA interpretations and don't change any the language of standards or codes. However, the task force's members agree to abide by the group's decisions to the extent practical.
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Peggy Desiderio (7/1/2009 at 1:32 PM)
I cannot believe JCAHO response to ED overcrowding. When there is no feasible way to flow pts there has to be the responsibility of the floor nurses to kick in.... is it safer for patients to sit in an overcrowded ED where the nurses have patient loads that are unimaginable on floors, a variety of patients with variety of medical needs as well the continuing influx of patients and their needs? so much has been said and fought for safe staffing ratios yet the ED is untouched by these ratios. Nurses are to be patient advocates, maybe I am naive but I thought that meant all nurses. In my facility, the manager has worked with increased staffing and tried to assist in all areas of pt traffic but there is the fact of actual area constraints. The walls do not stretch and the common complaint of ED nurses is the floor nurses NOT taking patients. The ENA should assist JCAHO in advocating for the patients. As a patient or family member of a patient would you prefer your family member in an overcrowded area (many times the ED hallway) as opposed to the less crowded floor hallway as well as under the care of a less overloaded RN?