Emergency Department Boarding of Non-Trauma Patients Adversely Affects Trauma Patient Length of Stay

Abstract

Introduction Emergency Department (ED) boarding delays initiation of time-sensitive protocols for trauma patients and makes them susceptible to increased mortality and morbidity. In this study, we compared the ED boarding times of non-trauma patients and ED length of stay (LOS) of trauma patients. Methods This was a single-center retrospective cohort study in a Level 1 trauma center. The median boarding time among non-trauma patients and ED LOS among trauma patients was determined by month between the period of April 2018 to March 2019. Linear regression and Pearson correlation coefficient were used to express the magnitude and direction of the relationship between these two variables. Results During the study period, the mean number of non-trauma patients admitted in our ED per month was 1,154 and trauma patients was 89. The mean of the median boarding time per month for non-trauma patients was 76 minutes, and the mean of the median ED LOS per month for trauma patients was 198 minutes. There was a significant positive correlation between boarding time for non-trauma patients and ED LOS for trauma patients (Pearson correlation coefficient: 0.73; p = 0.007). Conclusion The long boarding times for non-trauma patients is associated with ED LOS for trauma patients, indicating that the total patient volume in the hospital contributes to the trauma patient's stay in the ED. Thus, ED LOS of trauma patients can be minimized by improving overall ED and hospital flow, including non-trauma patients.

Impact of interhospital transfer on emergency department timeliness of care and in-hospital outcomes of adult non-trauma patients

“…Patients who undergo IHT from one hospital to a referral center are often medically complex and require more advanced care with qualified staff, specialized services, and sophisticated technologies [ 3 , 4 ]. In particular, non-trauma patients remain the major population of ED visits and usually have heterogeneous types of diseases [ 5 , 6 ]. Non-trauma patients who present to the ED from IHT and non-IHT exhibit different properties [ 7 , 8 ].…”