Garson Chad, Hollander Judd E, Rhodes Karin V, Shofer Frances S, Baxt William G, Pines Jesse M
Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Ann Emerg Med. 2008 Jan;51(1):9-12, 12.e1-3. doi: 10.1016/j.annemergmed.2007.03.016. Epub 2007 May 9.
Admitted patients are frequently boarded in emergency departments (EDs) when hospitals are at full capacity, which lessens the ED's ability to treat new patients. One alternative is to board admitted patients in inpatient hallways. We assess ED patient preferences for boarding location.
We surveyed adult ED patients during a 4-week period on preferences for boarding location. Patients were eligible if they were currently being admitted through the ED and had experienced at least 1 previous hospital admission to ensure knowledge of both the ED and inpatient locations. Patients were asked to choose whether they would rather board in an ED hallway or an inpatient hallway or whether they had no preference. Survey responses were hypothetical and did not affect care or bed placement. We tested whether patient demographics, survey location (ED room or ED hallway), admission service, timing to room placement, time to admission request, and time to survey administration were associated with survey responses.
A total of 565 patients were approached; 87% consented to be interviewed. Of those consented, 88% of patients had been previously admitted, leaving 431 patients in the study group. A total of 64% (95% confidence interval [CI] 59% to 69%) had a preference for boarding location: 59% (95% CI 52% to 65%) preferred inpatient hallways and 41% (95% CI 35% to 48%) preferred ED hallways. Survey location, admission service, time to room placement, admission request, and survey administration were not associated with survey responses.
When hospitals are at full capacity, patients would rather board in inpatient hallways than ED hallways.
当医院满负荷运转时,急诊入院的患者常常被安置在急诊科(ED),这降低了急诊科治疗新患者的能力。一种替代方案是将急诊入院患者安置在住院部走廊。我们评估急诊科患者对安置地点的偏好。
我们在4周时间内对成年急诊科患者进行了关于安置地点偏好的调查。如果患者当前正通过急诊科入院且此前至少有过1次住院经历,以确保其对急诊科和住院部地点都有所了解,那么他们就符合条件。患者被要求选择他们更愿意被安置在急诊科走廊还是住院部走廊,或者是否没有偏好。调查回复是假设性的,不影响护理或床位安排。我们测试了患者人口统计学特征、调查地点(急诊室或急诊科走廊)、入院科室、安置到病房的时间、提出入院请求的时间以及进行调查的时间是否与调查回复相关。
总共接触了565名患者;87%同意接受访谈。在同意接受访谈的患者中,88%曾有过住院经历,研究组剩下431名患者。共有64%(95%置信区间[CI]59%至69%)对安置地点有偏好:59%(95%CI52%至65%)更喜欢住院部走廊,41%(95%CI35%至48%)更喜欢急诊科走廊。调查地点、入院科室、安置到病房的时间、入院请求以及进行调查的时间与调查回复均无关联。
当医院满负荷运转时,患者更愿意被安置在住院部走廊而非急诊科走廊。