title: Influence of available resources on medical practitioners' decision-making process and practice: study of a reference hospital emergency department.
abstract: OBJECTIVE
  To evaluate variations in the observation period in the emergency department (ED) in response to bed availability.
  
  
  METHODS
  A quasi-experimental pre-test post-test study without a control group was conducted in the ED observation ward over 2 1-month periods. During this time the only variable that changed was the number of beds available, which decreased from 20 (pre-test period) to 16 (post-test period).
  
  
  RESULTS
  The ED attended 7,725 patients: 3,706 patients in pre-test period, 335 of whom were admitted to the observation ward, with an average length of stay of 1,105.4 minutes per patient, and 4,019 patients in post-test period, 570 of whom were admitted to the observation ward, with an average length of stay of 686.1 minutes per patient (p < 0.001). There was no variation in mortality, re-admissions or complaints.
  
  
  CONCLUSIONS
  A reduction in bed availability for observation purposes shortens patient length of stay.
authors.affiliation: Arnau de Vilanova University Hospital, School of Medicine, University of Lleida, Lleida, Spain. vinyes@cirurgia.udl.es
authors.forename: Juan
authors.initials: J
authors.lastname: Viñas Salas
authors.forename: Ramón
authors.initials: R
authors.lastname: Casals Garrigó
authors.forename: Ana M
authors.initials: AM
authors.lastname: Jiménez Vilchez
authors.forename: Pere
authors.initials: P
authors.lastname: Godoy
mesh_terms: D003657:Decision Making; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006295:Health Resources; D010820:Physicians