The emergency phenomenon of boarding, which refers to the “bad practice” of keeping patients awaiting admission on stretchers in the hallways of the Emergency Department (ED) for hours or, sometimes, days, is the primary cause of ED overcrowding. This practice is often necessitated by overcrowding, high influx during epidemics, or unfortunate events involving numerous people.
Post-Covid, many EDs have been exposed to chronic levels of overcrowding due to the lack of a “filter” from general practitioners.
Boarding in the ED has complex roots and disastrous consequences:
- For patients: increased morbidity, longer hospital stays, higher mortality rates, and increased suffering for those lying on stretchers in ED hallways;
- For healthcare workers: increased stress and burnout, decreased capacity to respond to emergencies and disasters;
- For the system: ambulance diversions or blocks, increased wait times in the ED.
This phenomenon incurs high costs in terms of care, extending hospital stay times, and poses the main threat to the quality of emergency services, affecting the timeliness of care, morbidity/mortality levels, the possibility of medical errors, and ambulance blocks.
Boarding is often caused by the depletion of ED stretchers due to patients inappropriately placed on them while waiting for a hospital bed, in addition to those used for the regular management of patients who will later be discharged.
Therefore, it becomes crucial to focus on analyzing the correct usage index of stretchers, as the flow of these aids is often not tracked. Consequently, even increasing the number of available stretchers would not effectively address the overcrowding issue. Starting from this premise, it is also possible to certify the real bed needs in departments, a contributing factor to ED overcrowding.
It is known that poor management of asset location can negatively impact the overall quality of service. Data from research in the most renowned sector journals are alarming: the time spent searching for electromedical devices within a hospital amounts to about 15% of an operator’s total shift duration, which is more than an hour of work. If we multiply this time across different shifts and the number of available operators, we realize how much stretcher efficiency and, in general, electromedical devices can impact ED overcrowding.
In this regard, TapMyLife has developed a stretcher tracking solution successfully implemented in some major Italian hospitals. The solution allows for real-time visualization on the facility’s floor plan of the last detected position of the asset. Positioning functionalities are accessible via both smartphone and fixed stations, allowing for rapid identification of the necessary device, reducing latency times in favor of better rationalization. Searches can be performed for individual devices or homogeneous groups of devices, and the functionality for indicating a free or occupied stretcher has been implemented.
In this way, ED operators have a tool that indicates the real-time position of stretchers (and wheelchairs), with the valuable indication of where they are located and, more importantly, whether they are truly occupied at that moment. The control room, on the other hand, has the actual usage index of individual assets and can determine, based on real, historical, and certified data, the actual needs for aids for the individual ED, with the certainty that the entire fleet of stretchers will be visible on a map and utilized to 100%.
Is this enough to solve the complexity of our ED problems? Certainly not, but we can confidently say, based on reliable data, that the TapMyLife ED Stretcher Management solution provides concrete and effective support to doctors, operators, and healthcare management in facing the daily challenges of emergency-urgent care departments.
