An initiative to reduce psychiatric boarding in a Cape Town emergency department

South African Journal of Psychiatry

Field Value
Title An initiative to reduce psychiatric boarding in a Cape Town emergency department
Creator Hendrikse, Clint A. Hodkinson, Peter van Hoving, Daniël J.
Subject Emergency medicine; psychiatry psychiatric boarding; access block; emergency medicine; readmission rate; crowding
Description Background: Psychiatric boarding in Emergency Departments (ED) is a global challenge which results in long ED length of stays (LOS) with significant consequences on patient care and staff safety.Aim: This study investigated the impact of an initiative to reduce psychiatric boarding on LOS and readmission rate, as well as explored the relationship between boarding times and LOS.Setting: This study was conducted at Mitchells Plain Hospital, a large district-level hospital in Cape Town.Methods: This cross-sectional study collected data for 24 months, which included a 9-month period prior to the initiative and 16 months thereafter. Data were collected retrospectively from official electronic patient registries. The initiative comprised of inpatient hallway boarding as a full-capacity protocol with the accompanying capacitation of psychiatric wards to accommodate the additional burden.Results: The initiative was associated with a decrease of 95% (p  0.001) in boarding time, 13% (p  0.001) in ward LOS and 25% (p  0.001) in hospital LOS. Ward LOS were found to be independent of ED boarding times. The readmission rate increased from 12% to 18% post intervention.Conclusion: The initiative resulted in a sustainable improvement in boarding times and LOSs. The observational nature of this study precludes concrete conclusions and further investigations into psychiatric inpatient hallway boarding are recommended.Contribution: Inpatient hallway boarding could be a feasible option to reduce the risk. Psychiatric boarding times in the ED are independent of ward LOS, rendering it devoid from any value from a lean and economic perspective.
Publisher AOSIS
Date 2023-11-14
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — cross-sectional
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajpsychiatry.v29i0.2075
Source South African Journal of Psychiatry; Vol 29 (2023); 8 pages 2078-6786 1608-9685
Language eng
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Coverage Cape Town; South Africa 2017-2019 —
Rights Copyright (c) 2023 Clint A. Hendrikse, Peter Hodkinson, Daniël J. van Hoving