title: Caring for inpatient boarders in the emergency department: improving safety and patient and staff satisfaction.
abstract: Hospital capacity constraints lead to large numbers of inpatients being held for extended periods in the emergency department. This creates concerns with safety, quality of care, and dissatisfaction of patients and staff. The aim of this quality-improvement project was to improve satisfaction and processes in which nurses provided care to inpatient boarders held in the emergency department. A quality-improvement project framework that included the use of a questionnaire was used to ascertain employee and patient dissatisfaction and identify opportunities for improvement. A task force was created to develop action plans related to holding and caring for inpatients in the emergency department. A questionnaire was sent to nursing staff in spring 2012, and responses from the questionnaire identified improvements that could be implemented to improve care for inpatient boarders. Situation-background-assessment-recommendation (SBAR) communications and direct observations were also used to identify specific improvements. Post-questionnaire results indicated improved satisfaction for both staff and patients. It was recognized early that the ED inpatient area would benefit from the supervision of an inpatient director, managers, and staff. Outcomes showed that creating an inpatient unit within the emergency department had a positive effect on staff and patient satisfaction.
authors.affiliation: Aurora, CO. Electronic address: Melanie.Bornemann-Shepherd@uchealth.org.
authors.forename: Melanie
authors.initials: M
authors.lastname: Bornemann-Shepherd
authors.affiliation: Aurora, CO.
authors.forename: Jamie
authors.initials: J
authors.lastname: Le-Lazar
authors.affiliation: Aurora, CO.
authors.forename: Mary Beth Flynn
authors.initials: MB
authors.lastname: Makic
authors.affiliation: Aurora, CO.
authors.forename: Deborah
authors.initials: D
authors.lastname: DeVine
authors.affiliation: Aurora, CO.
authors.forename: Kelly
authors.initials: K
authors.lastname: McDevitt
authors.affiliation: Aurora, CO.
authors.forename: Marcee
authors.initials: M
authors.lastname: Paul
mesh_terms: D000046:Academic Medical Centers; D016529:Emergency Nursing / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007400:Interprofessional Relations; D007588:Job Satisfaction; D007902:Length of Stay; D008297:Male; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D010347:Patient Care Planning / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D061214:Patient Safety; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D058996:Quality Improvement; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014481:United States