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 publicationSpring Simulation Multiconference 2009 - Co-located with the 2009 SISO Spring Simulation Interoperability Workshop
PublisherAssociation for Computing Machinery, Inc
StatePublished - Mar 22 2009
Event2009 Spring Simulation Multiconference, SpringSim 2009 - San Diego, United States
Duration: Mar 22 2009Mar 27 2009

Other

Other2009 Spring Simulation Multiconference, SpringSim 2009
CountryUnited States
CitySan Diego
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 Spring Simulation Multiconference 2009 - Co-located with the 2009 SISO Spring Simulation Interoperability Workshop [36] Association for Computing Machinery, Inc.

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.

Spring Simulation Multiconference 2009 - Co-located with the 2009 SISO Spring Simulation Interoperability Workshop. Association for Computing Machinery, Inc, 2009. 36.

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 Spring Simulation Multiconference 2009 - Co-located with the 2009 SISO Spring Simulation Interoperability Workshop., 36, Association for Computing Machinery, Inc, 2009 Spring Simulation Multiconference, SpringSim 2009, San Diego, 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 Spring Simulation Multiconference 2009 - Co-located with the 2009 SISO Spring Simulation Interoperability Workshop. Association for Computing Machinery, Inc. 2009. 36
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. Spring Simulation Multiconference 2009 - Co-located with the 2009 SISO Spring Simulation Interoperability Workshop. Association for Computing Machinery, Inc, 2009.
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