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ACEP Calls for Halt to ED Boarding

Cheryl Clark, for HealthLeaders Media, October 4, 2010

At Albany Medical College in New York, the length of stay dropped in half, said Daniel Pauze, MD. "It shows that we can get patients out of the ER and into inpatient beds if hospital leadership demands it. It's good for both patient safety and the hospital's bottom line when you stop people walking out the door without treatment."

Door-to-balloon times for heart attack patients also improved, another study showed, when the frequency of hospital boarding is reported to a hospital's governing boards.  That's significant in light of a Health Affairs report in 2008 showing that wait times for heart attack patients increased by 150% from 1997 to 2004, and that 25% of heart attack patients waited nearly an hour before seeing a doctor.

Emergency room visits in the U.S. increased to nearly 124 million in 2008, up from nearly 117 million in 2007, according to the Centers for Disease Control and Prevention.

See also:

AUDIO: Strategies to Manage ED Arrivals

A Night At the ER


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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3 comments on "ACEP Calls for Halt to ED Boarding"


michele (7/20/2011 at 10:48 AM)
I agree with James. We got people coming in for pregnancy tests, for stubbed toes, for ear infections, seasonal allergies and that was just yesterday. In 12 hours I saw 3 patients who needed an emergency room the rest were clinic patients. The best is when the pt tries to do the right thing and the clinic or their PCP office sends them into the ED for "faster test results". Really it is out of control.

James (10/6/2010 at 3:52 PM)
I don't suppose any of these rocket scientists have determined that the reason people are leaving the ED without being seen is because their condition doesn't justify an ED visit. What nobody wants to address is the elephant in the room called EMTLA. Change that and then ED's can return to their primary role. Which is addressing emergencys instead of being a 24 hour walk in clinic.

bob (10/4/2010 at 10:25 AM)
Many years ago, we solved this problem at a large teaching hospital with a very high occupancy rate. We did an analysis of emergency department patients requiring admission, and worked out a system in the admissions office to control the number of admissions of non-urgent in-patients each day so that beds would be available for the emergency cases. We found that we could do this without having to keep beds open on very many days when the predicted number of emergency admissions was less than estimated. We overcame opposition to this innovation of some of the surgical staff by allowing each member of the medical staff to admit no more than three non-urgent cases annually without question. This made all the difference in cooperation from the medical staff! The limitation on the number of non-urgent cases led to a great deal of voluntary innovation in medical staff management of their non-urgent cases and operating room scheduling: much more attention to prompt discharge of their in-patients; greater use of our ambulatory surgical facility; even getting us involved in improving quality at the other hospitals they were using!