The Impact of Inpatient Boarding on ED Efficiency: A Discrete-Event Simulation Study

Authors:
Aaron E. Bair;Wheyming T. Song;Yi-Chun Chen;Beth A. Morris
Affiliations:
Department of Emergency Medicine, University of California, Davis, Medical Center, Sacramento, USA;Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu, Taiwan;Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu, Taiwan;Department of Emergency Medicine, University of California, Davis, Medical Center, Sacramento, USA
Venue:
Journal of Medical Systems
Year:
2010

Citing 1
Cited 1

Simulation Modeling and Analysis (McGraw-Hill Series in Industrial Engineering and Management)

Simulation Modeling and Analysis (McGraw-Hill Series in Industrial Engineering and Management)

Using Electronic Medical Record Systems for Admission Decisions in Emergency Departments: Examining the Crowdedness Effect

Journal of Medical Systems

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Abstract

In this study, a discrete-event simulation approach was used to model Emergency Department's (ED) patient flow to investigate the effect of inpatient boarding on the ED efficiency in terms of the National Emergency Department Crowding Scale (NEDOCS) score and the rate of patients who leave without being seen (LWBS). The decision variable in this model was the boarder-released-ratio defined as the ratio of admitted patients whose boarding time is zero to all admitted patients. Our analysis shows that the Overcrowded+ (a NEDOCS score over 100) ratio decreased from 88.4% to 50.4%, and the rate of LWBS patients decreased from 10.8% to 8.4% when the boarder-released-ratio changed from 0% to 100%. These results show that inpatient boarding significantly impacts both the NEDOCS score and the rate of LWBS patient and this analysis provides a quantification of the impact of boarding on emergency department patient crowding.