UMEM Educational Pearls

Category: Administration

Title: A Unique Look at the Impact of Boarding

Keywords: Boarding, Mortality, Crowding (PubMed Search)

Posted: 9/22/2023 by Brent King, MD (Emailed: 10/7/2023) (Updated: 2/3/2024)
Click here to contact Brent King, MD

Takeaway Points - A 10 percent reduction in ED volume reduces an ED patient's chance of dying by 24% at 30 days and by 17% at six months

The author of this study conducted a unique natural experiment. They identified cases in which a new emergency department opened near one or more existing departments. Then, they confirmed that the opening of the new department was the only substantial change that occurred (e.g. the staff in the existing EDs were unchanged, the types of complaints were unchanged etc.). The author then determined the impact of the new ED on the existing ED's patient volume and compared death records from the existing EDs before and after the new ED opened.

Simply offloading 10 percent of patients from the existing ED to the new ED, significantly reduced the 30 day and six month risk of death for the existing ED's patients. 

The Bottom Line: Many studies have attempted to determine the impact of boarding and to tie boarding to morbitiy and mortality. This author's unique approach to the problem serves to reinforce the need for comprehensive solutions to the problem of patient boarding. Even a modest reduction in emergency department volume has a measureable impact on patient outcomes

References

Woodworth L. Swamped: Emergency department crowding and patient mortality. Journal of Health Economics, 2020; 70: 102279