Why Hospitals Need To Stop Boarding Patients In Emergency Rooms
James Blankenship RN, BSN, BHA, RLNC, SS(HC), LEAN(HC)
![James Blankenship RN, BSN, BHA, RLNC, SS(HC), LEAN(HC)]()
James Blankenship RN, BSN, BHA, RLNC, SS(HC), LEAN(HC)
Healthcare Executive and Leadership Consultant. I am dedicated to orchestrating the perfect synergy between exceptional talent and golden opportunities!
Original Article by Howard Forman in the WSJ
Note from Jim:
Overcrowding and Boarding in the ED has been the subject of discussion since I began my Nursing career....let's just say....decades ago! One interesting caveat that is not addressed in this article is the distinction between "no beds" and "no Nurses." Frequently, when hospitals are claiming "no beds" that is admin speak for "not enough Nurses to staff the beds". Staffing must always be part of the conversation when we talk about through put....you can have 20 open beds.....but if you do not have the Nurses to staff those beds....they may as well not exist. I have worked on many through put projects for facilities and many times they have patient beds in areas that are either under used or not used at all. The facilities that will win the through put challenges are the ones that will maximize under utilized areas for patient care and maximize staffing. Both ingredients must be flexible and nimble to change with fluctuation in Patients. Enjoy the main article. Jim
See the full article by Mr Forman at NursEtAl Blog
MSN, RN
7 年This is a huge problem everywhere it seems. People do not realize just how dangerous it is. In the ED where I work, we have a 1:4 patient ratio. When we board pts and they are critically ill, requiring more personalized care, our ratio doesn't change. In the ICU patient ratio is 1:2 and sometimes 1:1 for that reason. Pts require constant supervision to manage drips, vitals, and outcomes etc. When we board in the ED, the other pts we have get less attention and things can be easily missed. Not to mention, ED nursing is a different mindset from floor nursing. Both are eqully just as important. In the ED we fix them and stabilize them so they can go to the unit. We don't deal with what comes next. It isn't natural for us and again, things get missed. It is just a matter of time before a sentinel event occurs that could have easily been prevented with more staffing. Just one example of this happened just last weekend. We were holding patients in the ED. There were 2 ICU pts, 1 stepdown, and 1 M/S. A total of 10 pts in the ED. I had 3 RNs on staff with myself as charge and we got a call that a cardiac arrest was coming. That event tied up several RNs and our 1 ED physician for several hours. How can this even be justified?