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PSNet: Patient Safety Network
Journal Article

The association between transfer of emergency department boarders to inpatient hallways and mortality: a 4-year experience.

Viccellio A, Santora C, Singer AJ, et al. Annals of emergency medicine. 2009;54:487-91.

A 2006 Institute of Medicine report painted a grim picture of the current state of emergency care, and emergency department (ED) overcrowding was named as one of the major challenges. One strategy advocated for reducing ED overcrowding is transferring admitted patients who are boarding in the ED to the hallways of inpatient wards. This retrospective study found that patients who were transferred to hallways did not have an increased mortality rate compared with patients admitted directly to inpatient beds, although it should be noted that only lower-acuity patients were deemed appropriate for hallway transfer. A prior study found that ED boarders are at increased risk for adverse events, and an AHRQ WebM&M commentary discussed a missed test result in a boarding patient that had devastating clinical consequences.