Loza Andrew J, Sangal Rohit B, Gielissen Katherine A, Melnick Edward R, Sankey Christopher, Ostfeld-Johns Sharon
Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA; Department of Biomedical informatics and Data Science, Yale University School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, US Department of Veterans Affairs, West Haven, CT, USA.
Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA.
Am J Emerg Med. 2025 Mar;89:187-189. doi: 10.1016/j.ajem.2024.12.051. Epub 2024 Dec 22.
Boarding of admitted patients in the Emergency Department (ED) changes both the setting and teams providing care during the initial phase of admissions. We measured the waiting time from ED door arrival to inpatient floor arrival for 17,944 admissions to internal medicine services over a 5-year period from 2018 to 2023 and propose this as a metric for the total delay in care associated with ED boarding, termed "Door to Floor" (DTF) time. We find a sustained increase as well as significant seasonal and day-of-the-week variation in DTF times. DTF times increased over weekends and peaked on Monday suggesting a contribution from reduced number of discharges on weekends. The majority of DTF time arises from time in the ED after the disposition decision is made. Determining patterns in boarding time as well as of which phases of care contribute to boarding time can be used inform and track interventions.
急诊部（ED）收治患者会改变入院初始阶段的护理环境和护理团队。我们对2018年至2023年5年间内科服务的17944例入院患者从到达急诊部大门到到达住院楼层的等待时间进行了测量，并提议将此作为与急诊部收治相关的护理总延迟指标，称为“门到楼层”（DTF）时间。我们发现DTF时间持续增加，且存在显著的季节性和一周中不同日期的变化。DTF时间在周末增加，并在周一达到峰值，这表明周末出院人数减少起到了一定作用。大多数DTF时间是在做出处置决定后在急诊部的停留时间。确定收治时间模式以及护理的哪些阶段导致了收治时间，可用于为干预措施提供信息并进行跟踪。
