The impact of inpatient boarding on Emergency Department crowding

A discrete-event simulation study

Aaron E Bair, Wheyming T. Song, Yi Chun Chen, Beth A. Morris

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

The objective of this study was to investigate the effect of inpatient boarding on the degree of Emergency Department (ED) overcrowding. We developed a discrete-event simulation (DES) approach to model ED patient flow based on a census of 26,984 patients from January through May, 2008. We modeled the Emergency Department of the University of California, Davis, Medical Center (UCDMC). This hospital is a Level 1 academic trauma center with an annual ED census of approximately 60,000. We used the National Emergency Department Over-Crowding Scale (NEDOCS) as our primary performance metric. Our decision variable was the boarder-released-ratio, which we defined as the ratio of admitted patients whose boarding time is zero to all admitted patients. Our analysis shows that under the current boarder-released-ratio conditions at UCDMC, 88.4% of days were defined as "Overcrowded+" (a NEDOCS score of over 100). When the boarder-released-ratio was increased from 0% to 50%, Overcrowded+ days decreased from 88.4% to 68.0%. Likewise, when the boarder-released-ratio was 100% (no patients held in the ED awaiting inpatient beds), the Overcrowded+ ratio fell to 50.4%. These results show that inpatient boarding significantly impacts the NEDOCS score. This analysis provides a quantification of the impact of boarding on emergency department patient crowding.

Original languageEnglish (US)
Title of host publication42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference
Pages49-55
Number of pages7
StatePublished - 2009
Event42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference - San Diego, CA, United States
Duration: Mar 22 2009Mar 27 2009

Other

Other42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference
CountryUnited States
CitySan Diego, CA
Period3/22/093/27/09

Fingerprint

Discrete event simulation
Discrete Event Simulation
Emergency
Simulation Study
Census
Performance Metrics
Quantification
Annual
Zero

Keywords

  • Discrete-event simulation
  • Emergency department overcrowding

ASJC Scopus subject areas

  • Modeling and Simulation

Cite this

Bair, A. E., Song, W. T., Chen, Y. C., & Morris, B. A. (2009). The impact of inpatient boarding on Emergency Department crowding: A discrete-event simulation study. In 42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference (pp. 49-55)

The impact of inpatient boarding on Emergency Department crowding : A discrete-event simulation study. / Bair, Aaron E; Song, Wheyming T.; Chen, Yi Chun; Morris, Beth A.

42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference. 2009. p. 49-55.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Bair, AE, Song, WT, Chen, YC & Morris, BA 2009, The impact of inpatient boarding on Emergency Department crowding: A discrete-event simulation study. in 42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference. pp. 49-55, 42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference, San Diego, CA, United States, 3/22/09.
Bair AE, Song WT, Chen YC, Morris BA. The impact of inpatient boarding on Emergency Department crowding: A discrete-event simulation study. In 42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference. 2009. p. 49-55
Bair, Aaron E ; Song, Wheyming T. ; Chen, Yi Chun ; Morris, Beth A. / The impact of inpatient boarding on Emergency Department crowding : A discrete-event simulation study. 42nd Annual Simulation Symposium 2009, ANSS 2009, Part of the 2009 Spring Simulation Multiconference. 2009. pp. 49-55
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