Medicine and Health Sciences Commons^™

High Boarding Rates Of Older Adults In The Emergency Department: An On-Going Threat To Quality And Safety, Stacie Levine

Journal of Geriatric Emergency Medicine

No abstract provided.

Impact Of Mental Health Boarding In The Emergency Department And Recommendations On How We Can Improve, Kyra Buettner

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

Every year in the United States there is an estimated 2 million adolescents who experience suicidal ideation or attempt suicide.¹ The shortage of behavioral and mental health professionals has led to an increase in emergency department (ED) visits. “Boarding” is defined as “the practice of holding patients in the ED or another temporary location after the decision to admit or transfer has been made.²” The purpose of this study is to evaluate the following question - in adolescent patients with suicide attempt or mental health crisis, does boarding in the ED result in poorer mental health …

Determining Care Delivery Model Feasibility Using Discrete-Event-Simulation, Tanya Scott

Doctor of Nursing Practice (DNP) Projects

Background: The need for inpatient pediatric psychiatric services to address the growing issue of pediatric mental health in a multi-state integrated hospital enterprise is straining the system’s capacity to provide timely mental health care.

Local Problem: Lack of access to specialty pediatric psychiatric treatment for dual diagnosis medi-psychiatric care management is a patient quality and safety issue. Insufficient capacity contributes to longer emergency room boarding times and inpatient length of stay for patients who have a mental illness.

Methods: Use of digital simulation methodology to analyze the behavior of a dynamic event-driven care delivery workflow and to optimize quality patient …

Emergency Department Policies To Improve Care Experiences For Older Adults During The Covid-19 Pandemic, Anita Chary, Shan Lliu, Lauren Southerland, Lauren Cameron Comasco, Kei Ouchi, Christopher R. Carpenter Md, Msc, Edward W Boyer, Aanand D. Naik, Maura Kennedy

Journal of Geriatric Emergency Medicine

n/a

Boarding Barriers For Psychiatric Patients In Emergency Departments, Emmeline B. Martin Bsn, Rn, Alison Rossano Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Objective To identify past or current literature about emergency department holds and psychiatric patients consisting of the evaluation of patient outcomes, satisfaction and equity of care. It is already known that shorter boarding times from the emergency department to a psychiatric unit have positive patient outcomes such as a decrease in readmissions, increase in patient satisfaction and efficiency in appropriate treatment.

Method A scoping review to analyze data by grouping articles into themes which included authors, date of publication, aims/purpose, methodology, sample, interventional details, and the key findings in each article. Excluded articles included those discussing COVID-19 and case management. …

The Financial Effect Of Covid-19 On Children's Hospitals Without Pediatric Psychiatric Units, Patricia Tran

Theses, Dissertations and Capstones

Introduction: Boarding of pediatric psychiatric patients in emergency departments and inpatient medical units while awaiting placement in psychiatric facilities was common before the COVID-19 pandemic and was associated with significant hospital cost. The COVID-19 pandemic triggered a mental health crisis in the pediatric population. This study looked at the how the COVID-19 pandemic affected pediatric psychiatric boarding and the effects of pediatric psychiatric boarding on hospital finances.

Methodology: The methodology of this study utilized a literature review with semi-structured interviews of local subject matter experts. The literature review analyzed the effects of the COVID-19 precipitated pediatric mental health …

Improving Care Of Behavioral Health Patients In A Rural Emergency Department: A Needs Assessment, Margaret Perec

Doctoral Projects

Leadership and staff at a rural Critical Access Hospital (CAH)have identified the need for interventions to address the specific care issue of behavioral health patients presenting to the emergency department (ED). The ED has experienced a higher than expected number of visits, which has presented the department with challenges, especially in finding placements for patients who need inpatient treatment. ED management and staff have reported many patients have experienced long lengths of stay in the ED while waiting for beds.

A needs assessment attempts to identify characteristics of patients who remain in the ED for extended lengths of time, and …

Perfecting Patient Bed Flow In The Emergency Department, Kim-Sun Moreira

Walden Dissertations and Doctoral Studies

Emergency department (ED) crowding is a serious problem in the United States. Crowding in the ED can result in delays that may negatively affect patient outcomes and increase the cost of care. The purpose of this project was to understand strategies that can help to improve patient flow in the ED. The plan-to-do-study act model for process improvement influenced this project. Secondary data were collected for a 2-month period to determine the impact of workflow processes (patient boarding time in ED, surge capacity and workflow processes including the impact of ancillary departments) on the movement of admitted patients from the …

Boarding Patients Who Require Involuntary Mental Health Examinations In Florida, Laura H. Brennaman

Nursing ETDs

This study addressed the gaps in knowledge about psychiatric boarding with the aims of (a) determining the extent of psychiatric boarding in Florida hospitals for individuals meeting criteria for involuntary psychiatric examination and (b) explaining what health services system resources and individual patient determinants contribute to psychiatric boarding. Individuals who go to general hospital emergency departments (EDs) in need of involuntary mental health examinations sometimes must wait in EDs for admission to inpatient units because of the critical shortage of inpatient or crisis mental health services. The process of keeping patients in the ED who are waiting 4 hours or …

Boarding And Press Ganey Patient Satisfaction Scores Among Discharged Patients - Quantifying The Relationship, Paris B. Lovett

Paris B Lovett

Boarding and Press Ganey Patient Satisfaction Scores Among Discharged Patients - Quantifying the Relationship

Paris B. Lovett, Frederick T. Randolph, Rex G. Mathew

Thomas Jefferson University, Philadelphia, PA

Background: Long wait times, long length of stay, use of hallway beds, and physical crowding have all been reported to negatively affect patient satisfaction. There is a need for quantitative assessment of the relationship among patients discharged from the ED.

Objectives: To describe the association between total boarding hours for given calendar days, and mean Press Ganey patient satisfaction raw scores (PGs) on those days. To determine a quantitative coefficient for the …