Exploring the experience of boarded psychiatric patients in adult emergency departments.


Journal

BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559

Informations de publication

Date de publication:
27 09 2021
Historique:
received: 20 05 2021
accepted: 25 08 2021
entrez: 28 9 2021
pubmed: 29 9 2021
medline: 26 10 2021
Statut: epublish

Résumé

This study quantifies the frequency of adverse events (AEs) experienced by psychiatric patients while boarded in the emergency department (ED) and describes those events over a broad range of categories. A retrospective chart review (RCR) of adult psychiatric patients aged 18-55 presenting to one of four Calgary EDs (Foothills Medical Centre (FMC), the Peter Lougheed Centre (PLC), the Rockyview General Hospital (RGH), and South Health Campus (SHC)) who were subsequently admitted to an inpatient psychiatric unit between January 1, 2019 and May 15, 2019 were eligible for review. A test of association was used to determine the odds of an independent variable being associated with an adverse event. During the study time period, 1862 adult patients were admitted from EDs (city wide) to the psychiatry service. Of the 200 charts reviewed, the average boarding time was 23.5 h with an average total ED length of stay of 31 h for all presentations within the sample. Those who experienced an AE while boarded in the ED had a significantly prolonged average boarding time (35 h) compared to those who did not experience one (6.5 h) (p = 0.005). The length of time a patient is in the emergency department and the length of time a patient is boarded after admission significantly increases the odds that the patient will experience an AE while in the ED. Other significant factors associated with AEs include the type of admission and the hospital the patient was admitted from.

Sections du résumé

BACKGROUND
This study quantifies the frequency of adverse events (AEs) experienced by psychiatric patients while boarded in the emergency department (ED) and describes those events over a broad range of categories.
METHODS
A retrospective chart review (RCR) of adult psychiatric patients aged 18-55 presenting to one of four Calgary EDs (Foothills Medical Centre (FMC), the Peter Lougheed Centre (PLC), the Rockyview General Hospital (RGH), and South Health Campus (SHC)) who were subsequently admitted to an inpatient psychiatric unit between January 1, 2019 and May 15, 2019 were eligible for review. A test of association was used to determine the odds of an independent variable being associated with an adverse event.
RESULTS
During the study time period, 1862 adult patients were admitted from EDs (city wide) to the psychiatry service. Of the 200 charts reviewed, the average boarding time was 23.5 h with an average total ED length of stay of 31 h for all presentations within the sample. Those who experienced an AE while boarded in the ED had a significantly prolonged average boarding time (35 h) compared to those who did not experience one (6.5 h) (p = 0.005).
CONCLUSIONS
The length of time a patient is in the emergency department and the length of time a patient is boarded after admission significantly increases the odds that the patient will experience an AE while in the ED. Other significant factors associated with AEs include the type of admission and the hospital the patient was admitted from.

Identifiants

pubmed: 34579676
doi: 10.1186/s12888-021-03446-1
pii: 10.1186/s12888-021-03446-1
pmc: PMC8477559
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

473

Informations de copyright

© 2021. The Author(s).

Références

Ann Emerg Med. 2009 Sep;54(3):381-5
pubmed: 19303168
Health Aff (Millwood). 2010 Sep;29(9):1637-42
pubmed: 20820019
J Emerg Med. 2016 Jan;50(1):143-52
pubmed: 26409675
West J Emerg Med. 2012 Feb;13(1):26-34
pubmed: 22461918
West J Emerg Med. 2014 Feb;15(1):1-6
pubmed: 24578760
West J Emerg Med. 2012 Feb;13(1):51-6
pubmed: 22461921
PLoS One. 2013 Sep 12;8(9):e74214
pubmed: 24069281

Auteurs

Daniel Major (D)

Faculty of Science and Technology, Mount Royal University, Calgary, AB, Canada.

Katherine Rittenbach (K)

Addictions & Mental Health Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada.

Frank MacMaster (F)

Addictions & Mental Health Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada.
Department of Psychiatry, Alberta Health Services, Calgary, AB, Canada.

Hina Walia (H)

Department of Emergency Medicine, Alberta Health Services, C231 Foothills Medical Centre, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada.

Stephanie D VandenBerg (SD)

Department of Emergency Medicine, Alberta Health Services, C231 Foothills Medical Centre, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada. stephanie.vandenberg@ucalgary.ca.
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. stephanie.vandenberg@ucalgary.ca.

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