Care in a hallway is better than a crowded emergency room

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Boarding patients -- keeping them in the emergency room while they await admission to the hospital -- is a key reason that emergency rooms are so crowded. Many ERs have to stop accepting new patients until the backlog clears. But a new study suggests it’s safer to move patients out of the emergency room to an in-patient hallway while awaiting a hospital bed.

Researchers from Stony Brook University in Stony Brook, N.Y., studied 57,487 patients who were admitted to the hospital from the emergency department. Admitted patients were moved to in-patient hallways if they were stable, there were more than three admitted patients already boarded in the emergency department and there was no space to see incoming emergency patients. The study found that while patients admitted to in-patient hallways had longer wait times overall to admission, their death rate was 1.1% compared with 2.5% for patients admitted to normal rooms from the emergency room. Moreover, their rate of admission to the intensive care unit was much lower: 2.6% compared with 6.9%.

Though lying on a gurney in a hallway isn’t ideal, it appears to be safer than waiting in the chaotic and crowded emergency room, the study authors concluded. ‘Boarding admitted patients in the emergency department has been established as harmful for both the patients who are boarded and new patients coming to the emergency department who suffer long delays in care because emergency physicians are still monitoring the boarded patients,’ said Dr. Peter Viccellio, the lead author of the study. Viccellio presented the research today in Chicago at the annual meeting of the American College of Emergency Physicians.

-- Shari Roan