Bed Utilization and Overcrowding in a High-Volume Tertiary Level Pediatric Emergency Department

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Nisha Vengassery Balakrishnan Menon1, Muralidharan Jayashree2, Karthi Nallasamy1

  • 1Pediatric Emergency and Intensive Care Units, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Indian Pediatrics
|February 26, 2021
PubMed

Insights

Pediatric emergency department (ED) overcrowding, measured by bed occupancy rate (BOR), significantly increased patient mortality and care discontinuation. Addressing ED crowding is crucial for improving pediatric patient outcomes.

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Management
  • Patient Outcomes

Background:

  • High-volume pediatric emergency departments (EDs) face challenges with bed utilization and overcrowding.
  • Understanding the impact of overcrowding on patient outcomes is critical for quality improvement.

Purpose of the Study:

  • To quantify bed utilization and overcrowding in a busy pediatric ED.
  • To determine the correlation between ED overcrowding and adverse patient outcomes.

Main Methods:

  • Prospective enrollment of pediatric patients (excluding neonates) in a 22-bed ED over 11 months.
  • Collection of daily data on admissions, boarders, discharges, transfers, length of stay (LOS), and unfavorable outcomes (care discontinuation, deaths).
  • Calculation of daily bed occupancy rate (BOR) and correlation with unfavorable outcomes.

Main Results:

  • Over 17,000 pediatric visits were recorded, with a median daily admission of 22 patients.
  • The median number of boarders was 48, and the median BOR was 218%, indicating significant overcrowding.
  • Increased boarders and BOR were positively correlated with unfavorable outcomes (P<0.001).

Conclusions:

  • Pediatric ED overcrowding is directly linked to higher rates of care discontinuation and mortality.
  • Systemic interventions are necessary to mitigate ED overcrowding and improve patient safety.
Abstract

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