Risk Factors, Costs, and Impacts of ED Boarding

University of Maryland, Baltimore30,486 enrolled

Overview

The goal of this observational study is to learn about the risk factors, costs, and operational impacts of emergency department boarding (patients admitted to the hospital but remaining in the emergency department awaiting placement on an inpatient floor) The main questions it aims to answer is: 1. What characteristics of patients make them more likely to experience ED boarding? 2. What is the impact of ED boarding on costs of health care? 3. How do high-boarding environments affect the clinical care of all patients in the emergency department, including those that do not board themselves. Data will be secondary in nature, collected in the regular Participants already taking intervention A as part of their regular medical care for RA will answer online survey questions about their joint pain for 5 years.

Study Type

OBSERVATIONAL

Enrollment

30,486

Conditions

Stroke (CVA) or TIA Diabetes Asthma (Diagnosis)COPD (Chronic Obstructive Pulmonary Disease)Sepsis Hypertension

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * adults presenting to UMMS system hospitals and getting hospitalized by inpatient or observation over study period (2022-2025). At UMMC, should be admitted to an internal medicine team Med 1-4, Med 6, Med 5, med/surg/tele level (no IMC/ICU) and neuro floor level. Exclusion Criteria: * Patients admitted to cardiology, cancer center, surgical services, IMC/ICU

Outcomes

Primary Outcomes

Boarding time

Time between admission order placement and ED departure. Only patients admitted to services that routinely take primary care responsibility for boarding patients in the ED will be classified as boarders

Time frame: During hospitalization encounter

Secondary Outcomes

Boarding Percentage

Proportion of hospitalization spent as ED boarder

Time frame: During hospital encounter

Direct variable cost

Cost. Includes direct nursing salary / fringe costs, medical supplies, drugs, ancillaries, etc. that are directly related to and highly variable with clinical volume

Time frame: During hospitalization

Hospital length of stay

Time frame: During hospitalization

Boarding Density Ratio

Percentage of ED beds occupied by boarders during a patient's stay, calculated hourly and averaged across the patient's entire ED visit

Time frame: During patient's ED stay