Emergency Department Productivity: Accounting for Boarded Patients-Emergency Department Productivity: Accounting for Boarded Patients

Pdf Summary

This executive synopsis provides an overview of the impact of boarding admitted patients in the emergency department (ED) on quality, safety, patient experience, financials, and regulations. Boarding practices in the ED can result in fragmented care, compromised patient safety and quality, increased potential for medical errors, delayed or missed orders, and longer ED length of stay. Boarded patients experience anxiety and uncertainty due to prolonged waiting for an inpatient bed, which can also lead to waiting room delays and increased risks of patients leaving without being seen.<br /><br />Financially, boarding patients can lead to lost revenue through increased rates of patients leaving without being seen and increased hospital length of stay. It can also negatively impact a hospital's community image, relations with private physicians, staff morale, and staff turnover. From a regulatory perspective, the Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC) have quality indicators related to ED length of stay for admitted patients.<br /><br />The document also discusses various accounting methodologies for accounting for boarded patient care hours separately from routine ED care hours. These methodologies include calculations based on nurse to patient ratios in receiving units, conversion of boarding hours to patient hours and worked hours, and adjusting the ED census to account for boarded patients. Communication with finance administrators is crucial to effectively conveying the impact of boarding on ED productivity and making the case for additional resources.<br /><br />It is important for EDs to address the challenges associated with boarding admitted patients in order to improve patient outcomes, optimize productivity, and allocate resources appropriately. By implementing accounting methodologies and effectively communicating with finance administrators, EDs can better manage the care of boarded patients and ensure accurate measurement of care hours needed.

Meta Tag

emergency department crowding

emergency department boarding

emergency department patient safety

emergency department LWBS

emergency department TJC

emergency department wHPPV

Keywords

boarding admitted patients

emergency department

quality

safety

patient experience

financials

regulations

ED length of stay

lost revenue

staff turnover