A mixed-methods study of the quality of care provided to patients boarding in the emergency department: comparing emergency department and inpatient responsibility models.

摘要: Concern exists regarding care patients receive while boarding (staying in the emergency department [ED] after a decision to admit has been made). This exploratory study compares for such ED under "Inpatient Responsibility" (IPR) and "ED (EDR) models using mixed methods. The authors abstracted quantitative data from 1,431 patient charts admitted two academic hospitals 2004-2005 interviewed 10 providers qualitative data. compared delays logistic regression used provider interviews explore reasons findings. EDR had more receiving home medications over first 26 hours of admission but fewer boarding; delayed cardiac enzymes checks. Interviews revealed that culture, resource prioritization, systems issues made boarded challenging. A theoretically better responsibility model may not deliver because cultural, issues.