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The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding.
Franklin, Brian J; Vakili, Sharif; Huckman, Robert S; Hosein, Sarah; Falk, Nicholas; Cheng, Katherine; Murray, Maria; Harris, Sheila; Morris, Charles A; Goralnick, Eric.
Afiliación
  • Franklin BJ; University of Michigan Medical School, Ann Arbor, MI; Harvard Business School, Boston, MA. Electronic address: BrianJFr@umich.edu.
  • Vakili S; Harvard Business School, Boston, MA; Department of Medicine, Stanford Medicine, Palo Alto, CA.
  • Huckman RS; Harvard Business School, Boston, MA.
  • Hosein S; Eden Health, New York, NY; Brigham and Women's Hospital, Boston, MA.
  • Falk N; Harvard Business School, Boston, MA.
  • Cheng K; Harvard Business School, Boston, MA.
  • Murray M; Brigham and Women's Hospital, Boston, MA.
  • Harris S; Brigham and Women's Hospital, Boston, MA.
  • Morris CA; Division of General Internal Medicine and Primary Care, Department of Medicine, Boston, MA; Harvard Medical School, Boston, MA.
  • Goralnick E; Department of Emergency Medicine, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Ann Emerg Med ; 75(6): 704-714, 2020 06.
Article en En | MEDLINE | ID: mdl-31983501
Delayed access to inpatient beds for admitted patients contributes significantly to emergency department (ED) boarding and crowding, which have been associated with deleterious patient safety effects. To expedite inpatient bed availability, some hospitals have implemented discharge lounges, allowing discharged patients to depart their inpatient rooms while awaiting completion of the discharge process or transportation. This conceptual article synthesizes the evidence related to discharge lounge implementation practices and outcomes. Using a conceptual synthesis approach, we reviewed the medical and gray literature related to discharge lounges by querying PubMed, Google Scholar, and Google and undertaking backward reference searching. We screened for articles either providing detailed accounts of discharge lounge implementations or offering conceptual analysis on the subject. Most of the evidence we identified was in the gray literature, with only 3 peer-reviewed articles focusing on discharge lounge implementations. Articles generally encompassed single-site descriptive case studies or expert opinions. Significant heterogeneity exists in discharge lounge objectives, features, and apparent influence on patient flow. Although common barriers to discharge lounge performance have been documented, including underuse and care team objections, limited generalizable solutions are offered. Overall, discharge lounges are widely endorsed as a mechanism to accelerate access to inpatient beds, yet the limited available evidence indicates wide variation in design and performance. Further rigorous investigation is required to identify the circumstances under which discharge lounges should be deployed, and how discharge lounges should be designed to maximize their effect on hospitalwide patient flow, ED boarding and crowding, and other targeted outcomes.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Lechos / Servicio de Urgencia en Hospital Tipo de estudio: Prognostic_studies / Sysrev_observational_studies Aspecto: Implementation_research Límite: Humans País/Región como asunto: America do norte / Europa Idioma: En Revista: Ann Emerg Med Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Lechos / Servicio de Urgencia en Hospital Tipo de estudio: Prognostic_studies / Sysrev_observational_studies Aspecto: Implementation_research Límite: Humans País/Región como asunto: America do norte / Europa Idioma: En Revista: Ann Emerg Med Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos