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Is hallway care dangerous? An observational study.
Jeffrey A Rixe1, James H Liu1, Hudson A Breaud1
1Department of Emergency Medicine, Boston University School of Medicine, Boston, MA 02118, United States.
The American Journal of Emergency Medicine
|May 12, 2018
Summary
Caring for patients in Emergency Department (ED) hallways increases the odds of 30-day return to the ED and hospital readmission. Hallway care did not significantly impact mortality in this study.
Area of Science:
- Emergency Medicine
- Healthcare Management
- Patient Safety
Background:
- Hallway beds are increasingly used in Emergency Departments (EDs) due to crowding.
- Limited research exists on the adverse outcomes associated with hallway patient care.
Purpose of the Study:
- To examine the effects of hallway triage on 30-day outcomes.
- Investigate associations between hallway care and ED return, readmission, and mortality.
Main Methods:
- Retrospective cohort study comparing hallway patients (HP) to matched controls.
- Data analyzed from an urban, academic ED from 9/30/14 to 10/1/15.
- McNemar's test used to assess outcomes.
Main Results:
- Hallway patients (HP) had 2.0 times the odds of 30-day ED return.
- HP had 1.6 times the odds of inpatient readmission and 1.7 times the odds of observation readmission.
- No significant difference in mortality was observed (OR 0.80).
Conclusions:
- Hallway triage is associated with increased odds of 30-day ED return and readmission.
- The association between hallway care and return to ED remained after adjusting for triage severity.
- Small sample size limited the analysis of hallway care effects on mortality.
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