Resumo

HENDRIKSE, Clint A.; HODKINSON, Peter  e  VAN HOVING, Daniël J.. An initiative to reduce psychiatric boarding in a Cape Town emergency department. S. Afr. j. psyc. [online]. 2023, vol.29, n.1, pp.1-8. ISSN 2078-6786.  http://dx.doi.org/10.4102/sajpsychiatry.v29i0.2075.

BACKGROUND: Psychiatric boarding in Emergency Departments (ED) is a global challenge which results in long ED length of stays (LOS) with significant consequences on patient care and staff safety AIM: This study investigated the impact of an initiative to reduce psychiatric boarding on LOS and readmission rate, as well as explored the relationship between boarding times and LOS SETTING: This study was conducted at Mitchells Plain Hospital, a large district-level hospital in Cape Town METHODS: This cross-sectional study collected data for 24 months, which included a 9-month period prior to the initiative and 16 months thereafter. Data were collected retrospectively from official electronic patient registries. The initiative comprised of inpatient hallway boarding as a full-capacity protocol with the accompanying capacitation of psychiatric wards to accommodate the additional burden RESULTS: The initiative was associated with a decrease of 95% (p < 0.001) in boarding time, 13% (p < 0.001) in ward LOS and 25% (p < 0.001) in hospital LOS. Ward LOS were found to be independent of ED boarding times. The readmission rate increased from 12% to 18% post intervention CONCLUSION: The initiative resulted in a sustainable improvement in boarding times and LOSs. The observational nature of this study precludes concrete conclusions and further investigations into psychiatric inpatient hallway boarding are recommended CONTRIBUTION: Inpatient hallway boarding could be a feasible option to reduce the risk. Psychiatric boarding times in the ED are independent of ward LOS, rendering it devoid from any value from a lean and economic perspective

Palavras-chave : psychiatric boarding; access block; emergency medicine; readmission rate; crowding.

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