Access block and prolonged length of stay in the emergency department are associated with a higher patient mortality rate

Cheng, Ting; Pan, Qian; Jin, Ya-qing; Yu, Haochen; Zhong, Pei-song; Gu, Wei‐Min; Wang, Xiaoshan; Yiming, LU; Luo, Li

doi:10.5847/wjem.j.1920-8642.2022.006

Cited by 8 publications

(14 citation statements)

References 22 publications

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“…Prolonged ED length of stay is associated with patient mortality and morbidity 6,7,11–13 . Here we showed that prolonged length of stay greater than 24 h was associated with lower HH compliance.…”

Section: Discussionmentioning

confidence: 60%

“…Prolonged ED length of stay is associated with patient mortality and morbidity. 6,7,[11][12][13] Here we showed that prolonged length of stay greater than 24 h was associated with lower HH compliance. Our data showed that the majority of these patients ($84%) were awaiting either an inpatient bed or transfer to another health facility.…”

Section: Discussionmentioning

confidence: 62%

“…2,14 Prolonged ED length of stay is also associated with similar factors that contribute to increased ED workload. 11,12 Therefore, it is possible that prolonged ED length of stay is simply a marker for these factors. In addition, it was not possible from the present study to differentiate whether increased LOS24 was specifically due to overcrowding and/or access block, although we speculate that it is likely a combination of these two factors.…”

Section: Discussionmentioning

confidence: 99%

“…Low rates of HH compliance are known to be associated with increased workload in ED, with contributing factors such as high and unpredictable patient volumes, increasing patient acuity and insufficient staffing 2,14 . Prolonged ED length of stay is also associated with similar factors that contribute to increased ED workload 11,12 . Therefore, it is possible that prolonged ED length of stay is simply a marker for these factors.…”

Section: Discussionmentioning

confidence: 99%

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Prolonged length of stay is associated with reduced hand hygiene compliance in the emergency department: A single centre retrospective study

Tsao

Macdonald

Dwyer

et al. 2022

Emerg Medicine Australasia

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Objective: To examine whether patient flow factors in the ED such as prolonged length of stay are associated with hand hygiene (HH) compliance. Methods: We conducted a retrospective study at an urban district hospital utilising available data from January 2018 to December 2021. Compliance to the World Health Organization five moments of HH expressed as percentage of total moments observed were collated every 2 months. Patient flow measures including proportion of patients referred or discharged within 4 h (LOS4), proportion of patients with ED length of stay >24 h (LOS24) and total number of patient presentations, were obtained for each 2-month periods. The association between these patient flow measures and HH compliance was examined using Pearson's correlation (P < 0.05). Results: The results showed a moderate and significant association between rates of HH compliance and LOS24 (r = À0.48, P = 0.025). That is, lower proportion of patients with ED length of stay >24 h was associated with improved HH compliance. There was no significant correlation between HH compliance and LOS4 (r = 0.38, P = 0.085) or total number of ED presentations (r = À0.30, P = 0.17). Conclusions: The findings show that prolonged ED length of stay may explain, at least partly, lower rates of HH compliance. Improvements in ED HH compliance should also include strategies that enhance patient flow.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prolonged length of stay is associated with reduced hand hygiene compliance in the emergency department: A single centre retrospective study

Tsao

Macdonald

Dwyer

et al. 2022

Emerg Medicine Australasia

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“…In Ethiopia, almost 50% of patients remained in the ED without proper allocation [12 & ]. In China, only 40% of patients were finally admitted and patients remaining in the ED had a higher mortality rate [40]. Patients who left the hospital directly from the ED also had a higher chance of ED revisit within 30 days.…”

Section: Andandmentioning

confidence: 99%

Boarding in the emergency department: challenges and mitigation strategies

da Silva Ramos,

Freitas,

Machado

2024

Current Opinion in Critical Care

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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.

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Low Utility of Short-Term Rhythm Assessment Before Long-Term Rhythm Monitoring in Patients With Cryptogenic Stroke

Apple

Flomenbaum

Parker

et al. 2023

The American Journal of Cardiology

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Access block and prolonged length of stay in the emergency department are associated with a higher patient mortality rate

Cited by 8 publications

References 22 publications

Prolonged length of stay is associated with reduced hand hygiene compliance in the emergency department: A single centre retrospective study

Prolonged length of stay is associated with reduced hand hygiene compliance in the emergency department: A single centre retrospective study

Boarding in the emergency department: challenges and mitigation strategies

Low Utility of Short-Term Rhythm Assessment Before Long-Term Rhythm Monitoring in Patients With Cryptogenic Stroke

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