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A systems approach that uses predictive modeling to identify patients who are at risk of being admitted to the hospital and uses that information to initiate the complex and time-consuming bed management process earlier in the care continuum could potentially shorten the time during which patients wait in the ED to be transitioned into an inpatient bed, thus removing the exit block that causes boarding and subsequently reducing crowding [12].
Interact J Med Res 2023;12:e42016
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There are positive logistical and care-quality reasons for these bed reservations, but there are also financial reasons that may benefit the hospital yet contribute to ED boarding. For example, reserving beds for highly reimbursable elective procedures that might not be utilized [9], instead of opening the beds for the immediate needs of ED admissions, increases boarding.
JMIR Bioinform Biotech 2022;3(1):e38845
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Rigorous analysis suggests that exit block and emergency department boarding are the main causes of emergency department crowding [6,9-12]. Boarding is the retention of patients who have already been admitted to the hospital in the emergency department because they await assignment to an inpatient hospital bed [5]. Exit block is the delay that occurs when patients cannot be transitioned into the hospital for admission or discharged (home, rehabilitation, etc) in a timely manner [5,8].
JMIR Med Inform 2021;9(9):e30022
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