The association between length of emergency department boarding and hospital length of stay for patients with mental health and behavioural disorders

dc.contributor.advisorVan Hoving, D J
dc.contributor.advisorHodkinson, Peter W
dc.contributor.authorHendrikse, Clint
dc.date.accessioned2022-06-09T08:59:01Z
dc.date.available2022-06-09T08:59:01Z
dc.date.issued2022
dc.date.updated2022-06-09T08:58:09Z
dc.description.abstractBackground Psychiatric boarding in Emergency Departments is a global challenge. Patients with mental and behavioural disturbances are disproportionally affected with boarding times up to three times longer than other patients. This retrospective cross-sectional study investigated the impact of an initiative to reduce psychiatric boarding on length of stay and readmission rate, as well as exploring the relationship between boarding times and length of stay. Methods All adult patients referred over a 24-month period (June 2017 – May 2019) for psychiatric admission from the Emergency Department of a Cape Town district hospital were included. This included a 9-month period prior to the initiative, after which inpatient capacity was increased, and inpatient hallway boarding was implemented. Data relating to admission processes and outcomes were extracted from electronic registries. Results In total, 2607 patients were referred for psychiatric admission (2.7% of all Emergency Department patients). The initiative was associated with a decrease of 95% (56 vs 3 hours, p24-hour boarding category (351 vs 360 hours, p=0.047). The readmission rate increased from 12% to 18% post intervention. Conclusion A significant improvement in hospital length of stay and psychiatric boarding times occurred after the initiative was implemented. The benefits should be weighed up against a subsequent higher readmission rate. From a lean- and economical perspective, the results of this study suggest that psychiatric boarding equates to waste as it is independent of ward length of stay. The observational nature of this study precludes concrete conclusions and further investigations into psychiatric inpatient hallway boarding are recommended.
dc.identifier.apacitationHendrikse, C. (2022). <i>The association between length of emergency department boarding and hospital length of stay for patients with mental health and behavioural disorders</i>. (). ,Faculty of Health Sciences ,Division of General Surgery. Retrieved from http://hdl.handle.net/11427/36459en_ZA
dc.identifier.chicagocitationHendrikse, Clint. <i>"The association between length of emergency department boarding and hospital length of stay for patients with mental health and behavioural disorders."</i> ., ,Faculty of Health Sciences ,Division of General Surgery, 2022. http://hdl.handle.net/11427/36459en_ZA
dc.identifier.citationHendrikse, C. 2022. The association between length of emergency department boarding and hospital length of stay for patients with mental health and behavioural disorders. . ,Faculty of Health Sciences ,Division of General Surgery. http://hdl.handle.net/11427/36459en_ZA
dc.identifier.ris TY - Master Thesis AU - Hendrikse, Clint AB - Background Psychiatric boarding in Emergency Departments is a global challenge. Patients with mental and behavioural disturbances are disproportionally affected with boarding times up to three times longer than other patients. This retrospective cross-sectional study investigated the impact of an initiative to reduce psychiatric boarding on length of stay and readmission rate, as well as exploring the relationship between boarding times and length of stay. Methods All adult patients referred over a 24-month period (June 2017 – May 2019) for psychiatric admission from the Emergency Department of a Cape Town district hospital were included. This included a 9-month period prior to the initiative, after which inpatient capacity was increased, and inpatient hallway boarding was implemented. Data relating to admission processes and outcomes were extracted from electronic registries. Results In total, 2607 patients were referred for psychiatric admission (2.7% of all Emergency Department patients). The initiative was associated with a decrease of 95% (56 vs 3 hours, p24-hour boarding category (351 vs 360 hours, p=0.047). The readmission rate increased from 12% to 18% post intervention. Conclusion A significant improvement in hospital length of stay and psychiatric boarding times occurred after the initiative was implemented. The benefits should be weighed up against a subsequent higher readmission rate. From a lean- and economical perspective, the results of this study suggest that psychiatric boarding equates to waste as it is independent of ward length of stay. The observational nature of this study precludes concrete conclusions and further investigations into psychiatric inpatient hallway boarding are recommended. DA - 2022 DB - OpenUCT DP - University of Cape Town KW - Emergency Medicine LK - https://open.uct.ac.za PY - 2022 T1 - The association between length of emergency department boarding and hospital length of stay for patients with mental health and behavioural disorders TI - The association between length of emergency department boarding and hospital length of stay for patients with mental health and behavioural disorders UR - http://hdl.handle.net/11427/36459 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/36459
dc.identifier.vancouvercitationHendrikse C. The association between length of emergency department boarding and hospital length of stay for patients with mental health and behavioural disorders. []. ,Faculty of Health Sciences ,Division of General Surgery, 2022 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/36459en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDivision of General Surgery
dc.publisher.facultyFaculty of Health Sciences
dc.subjectEmergency Medicine
dc.titleThe association between length of emergency department boarding and hospital length of stay for patients with mental health and behavioural disorders
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPhil
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