Unravelling relationships: Hospital occupancy levels, discharge timing and emergency department access block

EMA - Emergency Medicine Australasia

Volumn 24, Issue 5, 2012, Pages 510-517

  Khanna, Sankalp ^a   Boyle, Justin ^a   Good, Norm ^a   Lind, James ^b  

^a CSIRO   (Australia)

^b QUEENSLAND HEALTH   (Australia)

Author keywords

Bed occupancy; Crowding; Discharge planning; Hospital bed capacity

Indexed keywords

ARTICLE; EMERGENCY WARD; HOSPITAL ADMISSION; HOSPITAL BED UTILIZATION; HOSPITAL DISCHARGE; HOSPITAL MANAGEMENT; HUMAN; OUTCOME ASSESSMENT; PRIORITY JOURNAL;

CHI-SQUARE DISTRIBUTION; EFFICIENCY, ORGANIZATIONAL; EMERGENCY SERVICE, HOSPITAL; HOSPITAL BED CAPACITY; HOSPITALS; HOSPITALS, PUBLIC; HUMANS; LENGTH OF STAY; PATIENT DISCHARGE; QUEENSLAND; RETROSPECTIVE STUDIES; TIME FACTORS;

EID: 84867328844     PISSN: 17426731     EISSN: 17426723     Source Type: Journal    
DOI: 10.1111/j.1742-6723.2012.01587.x     Document Type: Article

References (27)

1. Howard PK. Hospital overcrowding: an emergency department challenge. Emergency Medicine & Critical Care 2005; 19-20.
2. Forero R, Hillman K. Access block and overcrowding: a literature review. Prepared for the Australasian College for Emergency Medicine, 2008. Available from URL: http://www.acem.org.au/media/media_releases/Access_Block_Literature_Review_08_Sept_3.pdf [Accessed August 2012].
3. Hoot NR, Aronsky D. Systematic review of emergency department crowding: causes, effects, and solutions. Ann. Emerg. Med. 2008; 52: 126-136.
4. McCarthy ML. Overcrowding in emergency departments and adverse outcomes. Br. Med. J. 2011; 342: d2830.
5. Guttmann A, Schull MJ, Vermeulen MJ, Stukel TA. Research association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada. Br. Med. J. 2011; 342: d2983.
6. ACEP (American College of Emergency Physicians) Task Force. Emergency Department Crowding: High-Impact Solutions. Dallas: ACEP (American College of Emergency Physicians), 2008.
7. Cowan RM, Trzeciak S. Clinical review: Emergency department overcrowding and the potential impact on the critically ill. Crit. Care 2005; 9: 291-295.
8. Richardson DB, Mountain D. Myths versus facts in emergency department overcrowding and hospital access block. Med. J. Aust. 2009; 190: 369-374.
9. Australasian College for Emergency Medicine. Access block and overcrowding in emergency departments. 2004. Available from URL: http://www.acem.org.au/media/Access_Block1.pdf [Accessed August 2012].
10. Forero R, Hillman KM, McCarthy S, Fatovich DM, Joseph AP, Richardson DB. Access block and ED overcrowding. Emerg. Med. Australas. 2010; 22: 119-135.
11. Baggoley C, Owler B, Grigg M, Wellington H, Monaghan M, Hartley-Jones J. Expert Panel Review of Elective Surgery and Emergency Access Targets under the National Partnership Agreement on Improving Public Hospital Services. Report to the Council of Australian Governments, 30 June 2011. Canberra: Commonwealth of Australia, 2011. Available from URL: http://www.coag.gov.au/sites/default/files/Expert_Panel_Report%20D0490.pdf [Accessed August 2012].
12. Fatovich DM, Hughes G, McCarthy SM. Access block: it's all about available beds. Med. J. Aust. 2009; 190: 362-363.
13. Bagust A, Place M, Posnett JW. Dynamics of bed use in accommodating emergency admissions: stochastic simulation model. Br. Med. J. 1999; 319 (7203): 155-158.
14. Gorunescu F, McClean SI, Millard PH. A queueing model for bed-occupancy management and planning of hospitals. J. Oper. Res. Soc. 2002; 53: 19-24.
15. Forster AJ, Stiell I, Wells G, Lee AJ, Van Walraven C. The effect of hospital occupancy on emergency department length of stay and patient disposition. Acad. Emerg. Med. 2003; 10: 127-133.
16. Bain CA, Taylor PG, McDonnell G, Georgiou A. Myths of ideal hospital occupancy. Med. J. Aust. 2010; 192: 42-43.
17. Garling P. Final Report of the Special Commission of Inquiry. Acute Care Services in NSW Public Hospitals. Vol. 3. Sydney: NSW Government, 2008. Available from URL: http://www.dpc.nsw.gov.au/__data/assets/pdf_file/0020/34193/Volume_3_-_Special_Commission_Of_Inquiry_Into_Acute_Care_Services_In_New_South_Wales_Public_Hospitals.pdf [Accessed August 2012].
18. Hillier DF, Parry GJ, Shannon MW, Stack AM. The effect of hospital bed occupancy on throughput in the pediatric emergency department. Ann. Emerg. Med. 2009; 53: 767-76.e3.
19. Arkun A, Briggs WM, Patel S, Datillo PA, Bove J, Birkhahn RH. Emergency department crowding: factors influencing flow. West. J. Emerg. Med. 2010; 11: 10-15.
20. Rathlev NK, Chessare J, Olshaker J etal. Time series analysis of variables associated with daily mean emergency department length of stay. Ann. Emerg. Med. 2007; 49: 265-271.
21. Lucas R, Farley H, Twanmoh J etal. Emergency department patient flow: the influence of hospital census variables on emergency department length of stay. Acad. Emerg. Med. 2009; 16: 597-602.
22. Australian Institute of Health and Welfare. Australian hospital statistics 2008-09. Health Services Series No. 17. Cat. No. HSE 84. Canberra, 2010.
23. Australian Medical Association (AMA) Queensland. Your Hospital's Health. Available from URL: http://yourhospitalshealth.com.au/ [Accessed August 2012].
24. Australasian College for Emergency Medicine. ACEM Policy on Standard Terminology. 2009. Available from URL: http://www.acem.org.au/media/policies_and_guidelines/P02_-_Standard_Terminology_16.04.09.pdf [Accessed August 2012].
25. Powell ES, Khare RK, Venkatesh AK, Van Roo BD, Adams JG, Reinhardt G. The relationship between inpatient discharge timing and emergency department boarding. J. Emerg. Med. 2012; 42: 186-196.
26. Khanna S, Boyle J, Good N, Lind J. Impact of Admission and Discharge Peak Times on Hospital Overcrowding. Stud Health Technol Inform 2011; 168: 82-88.
27. Boyle J, Jessup M, Crilly J etal. Predicting emergency department admissions. Emerg. Med. J. 2012; 29: 358-365.