The impact of prolonged boarding of successfully resuscitated out-of-hospital cardiac arrest patients on survival-to-discharge rates

Association between boarding in the emergency department and in-hospital mortality: A systematic review

“…The main characteristics of the included studies are summarized in Table 1. Twelve studies were selected [28][29][30][31][32][33][34][35][36][37][38][39]. Eight were retrospective cohort studies, three were cross-sectional, and one was a prospective observational study.…”

“…Five studies were performed in the USA [30,[34][35][36][37]. Two studies were realized in Taiwan [31,39], one in South Korea [29], one in Thailand [33], two in Saudi Arabia [28,38], and one in Ireland [32]. A total of five studies investigated exclusively patients admitted to intensive care units (ICU).…”

“…A total of five studies investigated exclusively patients admitted to intensive care units (ICU). Two of these studies included ICU admissions for any type of condition [28,30] and three studies included ICU admissions for specific medical conditions: one study investigated cardiac arrest of out-of-hospital patients who boarded in the ED before being admitted [29], and the other two studies included patients with acute respiratory failure [31] and sepsis/septic shock patients [35], respectively.…”

Overcrowding in the Emergency Department and Patient Safety

“…Patients with non-ST elevation myocardial infarctions who board in the ED have increased adverse events and less adherence to standard of care therapy, and those admitted with chest pain have higher rates of adverse events [31,32]. Although ED crowding has not been found to have an impact on resuscitation outcomes or quality in patients sufering out of hospital cardiac arrest, boarding of patients with return of spontaneous circulation is associated with worse outcomes [33,34]. This relationship holds true for other critically ill patients who are held in the ED for lack of bed space in the intensive care unit [35].…”

A Real-Time Autonomous Dashboard for the Emergency Department: 5-Year Case Study (Preprint)

“…Influenced are such major quality factors as timeliness, effectiveness, efficiency, safety, and patient-centeredness, resulting in increased mortality and morbidity. [5,[8][9][10] Multiple studies have suggested using system engineering and science to improve ED performance, streamlining process and improving throughput. [11][12][13] However, a strategic approach to finding process delays and supply-demand mismatch by traditional hospital information systems (HISs) is not feasible.…”