Rising Alarm in Emergency Rooms, Study Advises Caution

Rising Alarm in Emergency Rooms, Study Advises Caution

The practice of boarding, where patients wait for hospital beds in emergency departments, has surged across the United States, posing a significant challenge to the nation's healthcare system. A comprehensive study analysing over 46 million emergency visits across 1,500 hospitals in all 50 states from 2017 through September 2024 has revealed that major causes of high boarding times include insufficient inpatient bed availability, particularly during peak infectious disease seasons, systemic inefficiencies in hospital admission processes, and increased patient demand.

The COVID-19 pandemic exacerbated this issue by precipitating unprecedented patient surges and ongoing strain on hospital capacity, leading to persistently long boarding times that have not resolved, contributing to overcrowding and delays in care. The pandemic heightened the frequency and duration of boarding, with boarding times reaching levels that risk healthcare system collapse if another pandemic or similar crisis occurs.

The study, published in Health Affairs by researchers from the University of Michigan Medical School and Beth Israel Deaconess Medical Center, found that nearly 5% of admitted patients during peak times waited 24 hours or more in emergency departments. This number rose to 35% during winter months, with more than 25% of admitted patients during non-peak months in 2022-2024 waiting four hours or more for a bed.

Adults aged 65 and older, Black patients, and patients whose primary language is not English or Spanish are affected more significantly by boarding. Moreover, backlogs in mental and behavioral health services often require prolonged ED stays, contributing to boarding.

The consequences of high boarding times are severe. They increase patient safety risks, contribute to clinician burnout, and lead to emergency department overcrowding. Reports of harm due to prolonged ED stays and overcrowding, as well as increased burnout, moral injury, and workplace violence related to high boarding conditions, may worsen workforce shortages in emergency medicine.

However, some hospitals have begun implementing AI-driven patient flow solutions to anticipate admissions earlier using real-time clinical data in order to reduce boarding times and improve ED throughput. These tools aim to predict admissions earlier and improve the efficiency of hospital admission processes, potentially mitigating the impact of high boarding times on patient care and clinician wellbeing.

In summary, the study reflects a national crisis, with over 90% of EDs overcrowded and boarding linked to increased patient mortality. The health system is at risk of collapse in the event of another pandemic due to sustained high levels of boarding. Efforts to address this issue are crucial to ensure the quality of care, emergency readiness, and the wellbeing of both patients and healthcare professionals.

1. Science has a significant role in addressing the challenge posed by the rise in boarding times in hospitals.
2. Medical-conditions and chronic diseases, such as chronic kidney disease and cancer, can be better managed with advancements in science.
3. Respiratory conditions like COVID-19 contribute to insufficient inpatient bed availability, leading to increased boarding times.
4. Digestive health can also be impacted by systemic inefficiencies in hospital admission processes.
5. Maintaining eye-health becomes challenging during prolonged boarding times in emergency departments.
6. Hearing issues might arise due to noise pollution in overcrowded hospitals.
7. Health-and-wellness is a broad term that encompasses various aspects of life, including fitness-and-exercise, which can help patients recover quickly from medical-conditions.
8. Climate-change can indirectly affect health by exacerbating chronic diseases through air pollution and temperature fluctuations.
9. Manufacturing industries should prioritize safety standards to minimize the risk of illness and hospitalization.
10. Mental-health issues, including anxiety and depression, can often be linked to chronic diseases or long hospital stays.
11. Cardiovascular-health is another crucial aspect of health that can be affected by emergency department overcrowding and delays in care.
12. The study's findings reflect the importance of industry collaboration in improving healthcare and environmental-science.
13. Finance plays a vital role in providing resources for the development of AI-driven patient flow solutions.
14. Energy-efficient solutions can help hospitals manage their resources better, reducing the strain on emergency departments.
15. Skin-conditions may develop due to prolonged hospital stays, necessitating adequate skin care during treatment.
16. Retail stores can contribute to a healthy lifestyle by offering a variety of products related to health-and-wellness, fitness-and-exercise, and cooking.
17. Interior-design can impact the mood and wellbeing of patients during hospital stays, contributing to a quicker recovery.
18. Cooking healthy meals at home can help manage chronic diseases and improve overall health.
19. Transportation infrastructure should be robust enough to ensure uninterrupted access to hospitals during emergencies.
20. Smartphones and wearables can help monitor health conditions and provide timely alerts to healthcare providers.
21. Smart-home-devices can assist in managing chronic diseases by automating regular health checkups reminders.
22. Cybersecurity measures are essential to protect sensitive health data stored in electronic health records from breaches.
23. A healthy lifestyle, including maintaining a balanced lifestyle, can help manage mental-health issues.
24. Outdoor-living and gardening can provide stress relief and contribute to sustainable-living, improving overall health.
25. Fashion-and-beauty products should prioritize health and safety, particularly for products used on the skin and around the eyes.
26. Food-and-drink choices, particularly those rich in antioxidants and vitamins, can help boost the immune system.
27. Dining experiences can foster relationships and mental wellbeing, but hygiene measures should be strictly followed to prevent the spread of diseases.
28. Family-dynamics can influence individuals' approach to personal-finance management, investing, and wealth-management.
29. Home-improvement projects, such as baking, gardening, or cooking, can foster a sense of accomplishment and promote a healthy lifestyle.

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