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Boarding in the emergency department: challenges and mitigation strategies.
da Silva Ramos, Fernando J; Freitas, Flavio G R; Machado, Flavia R.
Afiliação
  • da Silva Ramos FJ; Intensive Care Department - Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.
Curr Opin Crit Care ; 30(3): 239-245, 2024 06 01.
Article em En | MEDLINE | ID: mdl-38525875
ABSTRACT
PURPOSE OF REVIEW Herein, we conducted a review of the literature to better understand the issue of prolonged emergency department (ED) boarding by providing an overview of the current evidence on the available causes, consequences, and mitigation strategies. RECENT

FINDINGS:

Severely ill patients awaiting transfer to intensive care units (ICU) imposes additional burdens on the emergency care team from both a clinical and management perspective. The reasons for prolonged ED boarding are multifactorial. ED boarding compromises patients' safety and outcomes, and is associated with increased team burnout and dissatisfaction. Mitigation strategies include the optimization of patients' flow, the establishment of resuscitative care units, deployment of mobile critical care teams, and improvements in training. Staffing adjustments, changes in hospital operations, and quality improvement initiatives are required to improve this situation, while active bed management and implementation of capacity command centers may also help.

SUMMARY:

Considering the characteristics of healthcare systems, such as funding mechanisms, organizational structures, delivery models, access and quality of care, the challenge of ED boarding of critically ill patients requires a nuanced and adaptable approach. Solutions are complex but must involve the entirety of the hospital system, emergency department, staff adjustment, and education.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transferência de Pacientes / Serviço Hospitalar de Emergência Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transferência de Pacientes / Serviço Hospitalar de Emergência Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article