The Boarders in the Emergency Department (BED) study
Background and objectives:In the Boarders in the Emergency Department (BED) study the impact of overcrowding due to boarders on patients’ mortality and the likelihood of being diagnosed with methicillin resistant Staphylococcus aureus (MRSA) during admission was examined. With regard to efficiency,...
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| Veröffentlicht in: | Emergency medicine journal : EMJ 2008-05, Vol.25 (5), p.265-269 |
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| creator | Gilligan, P Winder, S Singh, I Gupta, V Kelly, P O Hegarty, D |
| description | Background and objectives:In the Boarders in the Emergency Department (BED) study the impact of overcrowding due to boarders on patients’ mortality and the likelihood of being diagnosed with methicillin resistant Staphylococcus aureus (MRSA) during admission was examined. With regard to efficiency, the impact of overcrowding on the time to first medical assessment for admitted patients, the number of patients leaving without being seen, and the rate of admission as a percentage of total emergency department attendances was explored.Methods:The retrospective cohort analysis study of all emergency department admissions was performed using information accessed via the Diver Solution. The software integrated information from several databases.Results:The average number of patients awaiting hospital admission in the emergency department at 09:00 was 20.4 (range 0–45). The average duration of stay in the emergency department following the decision to admit was 16.1 h (range 0–161 h). The number who did not wait (DNW) to be seen was strongly correlated with the time waiting for medical assessment, which in turn was correlated with the total number of attendances to the emergency department (p |
| doi_str_mv | 10.1136/emj.2007.048173 |
| format | Article |
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With regard to efficiency, the impact of overcrowding on the time to first medical assessment for admitted patients, the number of patients leaving without being seen, and the rate of admission as a percentage of total emergency department attendances was explored.Methods:The retrospective cohort analysis study of all emergency department admissions was performed using information accessed via the Diver Solution. The software integrated information from several databases.Results:The average number of patients awaiting hospital admission in the emergency department at 09:00 was 20.4 (range 0–45). The average duration of stay in the emergency department following the decision to admit was 16.1 h (range 0–161 h). The number who did not wait (DNW) to be seen was strongly correlated with the time waiting for medical assessment, which in turn was correlated with the total number of attendances to the emergency department (p<0.001). The elderly waited longer for admission and had the highest mortality and the highest chance of being diagnosed with MRSA during their overall admission.Conclusion:It is wrong for patients who are sick enough to require admission to hospital to be kept in the emergency department, and the entire health system must respond to their plight.</description><identifier>ISSN: 1472-0205</identifier><identifier>EISSN: 1472-0213</identifier><identifier>DOI: 10.1136/emj.2007.048173</identifier><identifier>PMID: 18434458</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cross Infection - etiology ; Crowding ; Emergency medical care ; Emergency Service, Hospital - standards ; Emergency Service, Hospital - statistics & numerical data ; Emergency services ; Female ; Hospital Mortality ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Intensive care ; Ireland - epidemiology ; Length of Stay - statistics & numerical data ; Male ; Methicillin Resistance ; Middle Aged ; Mortality ; Neurosurgery ; Patient Admission - standards ; Retrospective Studies ; Software ; Staphylococcal Infections - etiology ; Staphylococcus aureus - drug effects ; Staphylococcus infections ; Waiting Lists</subject><ispartof>Emergency medicine journal : EMJ, 2008-05, Vol.25 (5), p.265-269</ispartof><rights>2008 BMJ Publishing Group Ltd and the British Association for Emergency Medicine</rights><rights>Copyright: 2008 2008 BMJ Publishing Group Ltd and the British Association for Emergency Medicine</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b326t-7242bac6c77b72cad70f6c0359b1b2afea73d03d6bfa6d8adcf48adf22a9067a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://emj.bmj.com/content/25/5/265.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://emj.bmj.com/content/25/5/265.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3182,23551,27903,27904,77346,77377</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18434458$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gilligan, P</creatorcontrib><creatorcontrib>Winder, S</creatorcontrib><creatorcontrib>Singh, I</creatorcontrib><creatorcontrib>Gupta, V</creatorcontrib><creatorcontrib>Kelly, P O</creatorcontrib><creatorcontrib>Hegarty, D</creatorcontrib><title>The Boarders in the Emergency Department (BED) study</title><title>Emergency medicine journal : EMJ</title><addtitle>Emerg Med J</addtitle><description>Background and objectives:In the Boarders in the Emergency Department (BED) study the impact of overcrowding due to boarders on patients’ mortality and the likelihood of being diagnosed with methicillin resistant Staphylococcus aureus (MRSA) during admission was examined. With regard to efficiency, the impact of overcrowding on the time to first medical assessment for admitted patients, the number of patients leaving without being seen, and the rate of admission as a percentage of total emergency department attendances was explored.Methods:The retrospective cohort analysis study of all emergency department admissions was performed using information accessed via the Diver Solution. The software integrated information from several databases.Results:The average number of patients awaiting hospital admission in the emergency department at 09:00 was 20.4 (range 0–45). The average duration of stay in the emergency department following the decision to admit was 16.1 h (range 0–161 h). The number who did not wait (DNW) to be seen was strongly correlated with the time waiting for medical assessment, which in turn was correlated with the total number of attendances to the emergency department (p<0.001). The elderly waited longer for admission and had the highest mortality and the highest chance of being diagnosed with MRSA during their overall admission.Conclusion:It is wrong for patients who are sick enough to require admission to hospital to be kept in the emergency department, and the entire health system must respond to their plight.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cross Infection - etiology</subject><subject>Crowding</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital - standards</subject><subject>Emergency Service, Hospital - statistics & numerical data</subject><subject>Emergency services</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intensive care</subject><subject>Ireland - epidemiology</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Methicillin Resistance</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neurosurgery</subject><subject>Patient Admission - standards</subject><subject>Retrospective Studies</subject><subject>Software</subject><subject>Staphylococcal Infections - etiology</subject><subject>Staphylococcus aureus - drug effects</subject><subject>Staphylococcus infections</subject><subject>Waiting Lists</subject><issn>1472-0205</issn><issn>1472-0213</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkNtLwzAUh4MoTqfPvklBEBW6nVyatI_u4o0xGUwffAlpm2rn2s6kBfffm9ExwRdfTs4hX34nfAidYehhTHlfF4seARA9YCEWdA8dYSaIDwTT_V0PQQcdW7sAwEHEwkPUwSGjjAXhEWLzD-0NKmVSbayXl17t5nGhzbsuk7U30itl6kKXtXc1GI-uPVs36foEHWRqafXp9uyil7vxfPjgT57vH4e3Ez-mhNe-IIzEKuGJELEgiUoFZDwBGkQxjonKtBI0BZryOFM8DVWaZMzVjBAVAReKdtFlm7sy1VejbS2L3CZ6uVSlrhoreYSJiCh14MUfcFE1pnR_k1iEABAxCo7qt1RiKmuNzuTK5IUya4lBbnRKp1NudMpWp3txvs1t4kKnv_zWnwP8Fshtrb9398p8Si6oCOT0dSjpbPY2pWIgnxx_0_Kx2_Tf9h-j5Yql</recordid><startdate>200805</startdate><enddate>200805</enddate><creator>Gilligan, P</creator><creator>Winder, S</creator><creator>Singh, I</creator><creator>Gupta, V</creator><creator>Kelly, P O</creator><creator>Hegarty, D</creator><general>BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RQ</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>200805</creationdate><title>The Boarders in the Emergency Department (BED) study</title><author>Gilligan, P ; Winder, S ; Singh, I ; Gupta, V ; Kelly, P O ; Hegarty, D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b326t-7242bac6c77b72cad70f6c0359b1b2afea73d03d6bfa6d8adcf48adf22a9067a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cross Infection - etiology</topic><topic>Crowding</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital - standards</topic><topic>Emergency Service, Hospital - statistics & numerical data</topic><topic>Emergency services</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intensive care</topic><topic>Ireland - epidemiology</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Methicillin Resistance</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neurosurgery</topic><topic>Patient Admission - standards</topic><topic>Retrospective Studies</topic><topic>Software</topic><topic>Staphylococcal Infections - etiology</topic><topic>Staphylococcus aureus - drug effects</topic><topic>Staphylococcus infections</topic><topic>Waiting Lists</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gilligan, P</creatorcontrib><creatorcontrib>Winder, S</creatorcontrib><creatorcontrib>Singh, I</creatorcontrib><creatorcontrib>Gupta, V</creatorcontrib><creatorcontrib>Kelly, P O</creatorcontrib><creatorcontrib>Hegarty, D</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Career & Technical Education Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Emergency medicine journal : EMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gilligan, P</au><au>Winder, S</au><au>Singh, I</au><au>Gupta, V</au><au>Kelly, P O</au><au>Hegarty, D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Boarders in the Emergency Department (BED) study</atitle><jtitle>Emergency medicine journal : EMJ</jtitle><addtitle>Emerg Med J</addtitle><date>2008-05</date><risdate>2008</risdate><volume>25</volume><issue>5</issue><spage>265</spage><epage>269</epage><pages>265-269</pages><issn>1472-0205</issn><eissn>1472-0213</eissn><abstract>Background and objectives:In the Boarders in the Emergency Department (BED) study the impact of overcrowding due to boarders on patients’ mortality and the likelihood of being diagnosed with methicillin resistant Staphylococcus aureus (MRSA) during admission was examined. With regard to efficiency, the impact of overcrowding on the time to first medical assessment for admitted patients, the number of patients leaving without being seen, and the rate of admission as a percentage of total emergency department attendances was explored.Methods:The retrospective cohort analysis study of all emergency department admissions was performed using information accessed via the Diver Solution. The software integrated information from several databases.Results:The average number of patients awaiting hospital admission in the emergency department at 09:00 was 20.4 (range 0–45). The average duration of stay in the emergency department following the decision to admit was 16.1 h (range 0–161 h). The number who did not wait (DNW) to be seen was strongly correlated with the time waiting for medical assessment, which in turn was correlated with the total number of attendances to the emergency department (p<0.001). The elderly waited longer for admission and had the highest mortality and the highest chance of being diagnosed with MRSA during their overall admission.Conclusion:It is wrong for patients who are sick enough to require admission to hospital to be kept in the emergency department, and the entire health system must respond to their plight.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</pub><pmid>18434458</pmid><doi>10.1136/emj.2007.048173</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Cross Infection - etiology Crowding Emergency medical care Emergency Service, Hospital - standards Emergency Service, Hospital - statistics & numerical data Emergency services Female Hospital Mortality Hospitals Humans Infant Infant, Newborn Intensive care Ireland - epidemiology Length of Stay - statistics & numerical data Male Methicillin Resistance Middle Aged Mortality Neurosurgery Patient Admission - standards Retrospective Studies Software Staphylococcal Infections - etiology Staphylococcus aureus - drug effects Staphylococcus infections Waiting Lists |
| title | The Boarders in the Emergency Department (BED) study |
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