Monahan Ann Corneille, Feldman Sue S
University of Alabama at Birmingham, Birmingham, AL, United States.
Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States.
Interact J Med Res. 2023 Jul 10;12:e42016. doi: 10.2196/42016.
Emergency department (ED) crowding and its main causes, exit block and boarding, continue to threaten the quality and safety of ED care. Most interventions to reduce crowding have not been comprehensive or system solutions, only focusing on part of the care procession and not directly affecting boarding reduction. This position paper proposes that the ED crowding problem can be optimally addressed by applying a systems approach using predictive modeling to identify patients at risk of being admitted to the hospital and uses that information to initiate the time-consuming bed management process earlier in the care continuum, shortening the time during which patients wait in the ED for an inpatient bed assignment, thus removing the exit block that causes boarding and subsequently reducing crowding.
急诊科（ED）拥挤及其主要原因——出口阻塞和住院滞留，继续威胁着急诊护理的质量和安全。大多数减少拥挤的干预措施并非全面的系统解决方案，仅关注护理流程的一部分，并未直接影响住院滞留的减少。本立场文件提出，通过采用系统方法，利用预测模型识别有住院风险的患者，并利用这些信息在护理连续过程中更早地启动耗时的床位管理流程，缩短患者在急诊科等待住院床位分配的时间，从而消除导致住院滞留进而减少拥挤的出口阻塞，可最佳地解决急诊科拥挤问题。
