The Association Between Transfer of Emergency Department Boarders to Inpatient Hallways and Mortality: A 4-Year Experience
The Association Between Transfer of Emergency Department Boarders to Inpatient Hallways and Mortality: A 4-Year Experience
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DOI：
10.1016/j.annemergmed.2009.03.005
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发表时间：
2009-10-01
影响因子：
6.2
通讯作者：
Henry, Mark C.
中科院分区：
文献类型：
--
作者：
Viccellio, Asa;Santora, Carolyn;Henry, Mark C.
研究目的：我们制定并实施了一项机构协议，旨在通过让住院患者进入医院住院走廊来减少拥挤。我们假设，从急诊科（艾德）到住院hallows.Methods：这是一项回顾性队列研究，在郊区，学术艾德与每年的人口普查为70000的入院患者转移是可行的，而不是创建病人harmstholds.Methods。我们研究了2004年1月至2008年1月期间从我们的艾德收治的连续患者。2001年，一个多学科小组制定并实施了一项机构协议，其中在艾德住院的成年患者在选定的条件下被转移到医院住院走廊。我们从电子病历系统中提取数据，测量患者人口统计学、艾德分布（出院、入住楼层、入住走廊）、艾德住院时间和住院死亡率。我们报告艾德住院时间，随后转移到ICU，和住院死亡率的患者承认标准和走廊住院beds.Results：55,062艾德患者入院，有1,798例死亡。在所有入院者中，2,042人（4%）去了走廊; 53,020人去了标准床。入住标准床和走廊床的患者在年龄（中位数[四分位距]分别为55岁[37 - 72岁]和54岁[41 - 70岁]）和性别（分别为48.2%和50%的女性患者）方面相似。标准床和走廊床患者从艾德分诊到实际入院的中位（四分位距）时间分别为426分钟（306 ~ 600分钟）和624分钟（439 ~ 895分钟）（P
Study objective: We developed and implemented an institutional protocol aimed at reducing crowding by admitting boarded patients to hospital inpatient hallways. We hypothesized that transfer of admitted patients from the emergency department (ED) to inpatient hallways would be feasible and not create patient harm.Methods: This was a retrospective cohort study in a suburban, academic ED with an annual census of 70,000. We studied consecutive patients admitted from our ED between January 2004 and January 2008. In 2001, a multidisciplinary team developed and implemented an institutional protocol in which admitted adult patients boarded in the ED were transferred to hospital inpatient hallways under select conditions. We extracted data from the electronic medical record system, measuring patient demographics, ED disposition (discharge, admit to floor, admit to hallway), ED length of stay, and inhospital mortality. We report ED length of stay, subsequent transfer to an ICU, and hospital mortality of patients admitted to standard and hallway inpatient beds.Results: Of 55,062 ED patients admitted, there were 1,798 deaths. Of all admissions, 2,042 (4%) went to a hallway; 53,020 went to a standard bed. Patients admitted to standard and hallway beds were similar in age (median [interquartile range] 55 years [37 to 72 years] and 54 years [41 to 70 years], respectively) and sex (48.2% and 50% female patients, respectively). The median (interquartile range) times from ED triage to actual admission in patients admitted to standard and hallway beds were 426 minutes (306 to 600 minutes) and 624 (439 to 895 minutes) minutes, respectively (P