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Published on: January 16, 2019
Critical Care Consultations for Patients Boarding in the Emergency Department
Whitney Haley1, Rachel Smith2, Dana Mitchell3
1Whitney Haley is Pulmonary Critical Care Nurse Practitioner, Ascension Saint Thomas West Hospital, Nashville, Tennessee. Correspondence: 1708 North Side Dr, Murfreesboro, TN 37130 (wwilliams89@gmail.com).
Background:
During intensive care unit bed shortages, it is recommended that critically ill patients be cared for in the emergency department. Clarity is needed regarding admissions to the medical intensive care unit from the emergency department.
Objective:
To standardize treatment of critically ill patients and reduce time to critical care consultation through an interdepartmental model.
Methods:
Time to critical care consultation, intensive care unit length of stay, and proportion of short-stay intensive care unit admissions were evaluated before and after model implementation.
Results:
Mean time to consultation decreased significantly from before to after model implementation (113.9 vs 56 minutes). Mean intensive care unit length of stay increased from 2.8 to 3.4 days. The proportion of intensive care unit short stays decreased from 21.3% to 19.2%.
Conclusion:
The interdepartmental care model expedited critical care for boarding emergency department patients, increased intensive care unit length of stay, and slightly reduced short-stay admissions.
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