Population Consists of Patients Entering

¶ … population consists of patients entering the hospital through the emergency room; though this group is not comprised of a specific demographic or typified by specific symptoms or diseases, it is recognized as a special subset of patients both in terms of patient need and hospital operation. The more efficient release of patients from the emergency department has been suggested as a possible intervention to emergency room crowding, and this intervention is what has been assessed in this project as opposed to attempting inpatient admittance, which is the standard operation at most hospitals and the point of comparison herein. The desired outcomes include more positive health outcomes and increased institutional efficiency.

A six step model for change was utilized to design an intervention based on evidence gathered through research gathered on the PICO question. During assessment, it was determined that all stakeholders benefit from a change to current overcrowding practices in emergency departments, and this assessment was linked to the proposed intervention of ceasing inpatient boarding in emergency departments through more efficient release based on empirical evidence synthesized in the following step. Implementation and the subsequent steps of the chosen model were not accomplished, but were assessed inasmuch as possible.

The initial impetus to pursue this issue came from a cursory examination of literature that detailed the problem of emergency department overcrowding -- it's causes as well its detrimental effects on all points of hospital operation and on patient outcomes. Rather than used as places to assess and stabilize patients, emergency departments are increasing used as overflow for other parts of the hospital, or patients are admitted on an inpatient basis directly to the ED instead of to a true inpatient unit in the hospital. This created problems in the care of patients that should have been admitted to other units, as well as for all patients receiving care in the emergency department on an inpatient or an outpatient basis.