Journal of Critical Care
Volume 25, Issue 2 , Pages 184-189 , June 2010

Hospitalist bed management effecting throughput from the emergency department to the intensive care unit

  • Eric Howell, MD

      Affiliations

    • Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
    • Corresponding Author InformationCorresponding author. CIMS-Collaborative Inpatient Medicine Service, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA. Tel.: +1 410 550 5021; fax: +1 410 550 2972.
    • ,
  • Edward Bessman, MD

      Affiliations

    • Department of Emergency Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
    • ,
  • Robert Marshall, MBA

      Affiliations

    • Department of Emergency Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
    • ,
  • Scott Wright, MD

      Affiliations

    • Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA

References 

  1. Institute of Medicine (U.S.) , Committee on the Future of Emergency Care in the United States Health System . Hospital-based emergency care: at the breaking point. Washington, DC: National Academies Press; 2007;
  2. Pines JM, Hollander JE. Emergency department crowding is associated with poor care for patients with severe pain. Ann Emerg Med. 2008;51:1–5
  3. Pines JM, Localio AR, Hollander JE, Baxt WG, Lee H, Phillips C, et al. The impact of emergency department crowding measures on time to antibiotics for patients with community-acquired pneumonia. Ann Emerg Med. 2007;50:510–516
  4. Chalfin DB, Trzeciak S, Likourezos A, Baumann BM, Dellinger RP DELAY-ED study group. Impact of delayed transfer of critically ill patients from the emergency department to the intensive care unit. Crit Care Med. 2007;35:1477–1483
  5. Fee C, Weber EJ, Maak CA, Bacchetti P. Effect of emergency department crowding on time to antibiotics in patients admitted with community-acquired pneumonia. Ann Emerg Med. 2007;50:501–509
  6. Carr BG, Kaye AJ, Wiebe DJ, Gracias VH, Schwab CW, Reilly PM. Emergency department length of stay: a major risk factor for pneumonia in intubated blunt trauma patients. J Trauma. 2007;63:9–12
  7. Resche-Rigon M, Azoulay E, Chevret S. Evaluating mortality in intensive care units: contribution of competing risks analyses. Crit Care. 2006;10:R5
  8. Luce JM, Rubenfeld GD. Can health care costs be reduced by limiting intensive care at the end of life?. Am J Respir Crit Care Med. 2002;165:750–754
  9. Duke G, Green J, Briedis J. Survival of critically ill medical patients is time-critical. Crit Care Resusc. 2004;6:261–267
  10. Clark K, Normile LB. Influence of time-to-interventions for emergency department critical care patients on hospital mortality. J Emerg Nurs. 2007;33:6–13[quiz 90]
  11. Kralovec PD, Miller JA, Wellikson L, Huddleston JM. The status of hospital medicine groups in the United States. J Hosp Med. 2006;1:75–80
  12. Howell E, Bessman E, Kravet S, Kolodner K, Marshall R, Wright SM. Hospitalist bed management effecting ambulance diversion and emergency department throughput. Ann Intern Med. 2008;149:804–810
  13. Maryland Institute for Emergency Medical Services Systems (MIEMSS) . Region III: alert status system. Baltimore (Md): Maryland; 2005;
  14. Bond K, Ospina MB, Blitz S, Afilalo M, Campbell SG, Bullard M, et al. Frequency, determinants and impact of overcrowding in emergency departments in Canada: a national survey. Healthcare Quart. 2007;10(4):32–40
  15. Lynn SG, Kellerman AL. Critical decision making: managing the emergency department in an overcrowded hospital. Ann Emerg Med. 1991;20:287–292
  16. Rivers EP, Nguyen HB, Huang DT, Donnino MW. Critical care and emergency medicine. Curr Opin Crit Care. 2002;8:600–606
  17. McConnell KJ, Richards CF, Daya M, Bernell SL, Weathers CC, Lowe RA. Effect of increased ICU capacity on emergency department length of stay and ambulance diversion. Ann Emerg Med. 2005;45:471–478
  18. Olshaker JS, Rathlev NK. Emergency department overcrowding and ambulance diversion: the impact and potential solutions of extended boarding of admitted patients in the emergency department. J Emerg Med. 2006;30:351–356
  19. Kelen GD, Scheulen JJ, Hill PM. Effect of an emergency department (ED) managed acute care unit on ED overcrowding and emergency medical services diversion. Acad Emerg Med. 2001;8:1095–1100
  20. Nicholl J, West J, Goodacre S, Turner J. The relationship between distance to hospital and patient mortality in emergencies: an observational study. Emerg Med J. 2007;24:665–668
  21. Burt CW, McCaig LF, Valverde RH. Analysis of ambulance transports and diversions among US emergency departments. Ann Emerg Med. 2006;47:317–326
  22. McConnell KJ, Richards CF, Daya M, Weathers CC, Lowe RA. Ambulance diversion and lost hospital revenues. Ann Emerg Med. 2006;48:702–710
  23. Falvo T, Grove L, Stachura R, Zirkin W. The financial impact of ambulance diversions and patient elopements. Acad Emerg Med. 2007;14:58–62
  24. Auerbach AD, Landefeld CS, Shojania KG. The tension between needing to improve care and knowing how to do it. N Engl J Med. 2007;357:608–613

PII: S0883-9441(09)00228-7

doi: 10.1016/j.jcrc.2009.08.004

Journal of Critical Care
Volume 25, Issue 2 , Pages 184-189 , June 2010

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