The SimKit Podcast

The Twin Kiss of Death- Boarding and Crowding in the ED and How to Prevent It with Dr. Kraftin Schreyer

Jul 29, 2024

Dr. Kraftin Schreyer, an Emergency Medicine physician and ED Administrative Fellowship Director, dives deep into the pressing issues of boarding and crowding in emergency departments. He highlights the need for surge planning and collaboration to prevent these challenges. The discussion sheds light on operational distinctions between crowding and boarding and critiques traditional assessment tools. Emphasizing more practical metrics and improving patient flow through enhanced cooperation and discharge processes, Dr. Schreyer offers valuable strategies for tackling these systemic issues.

32:28

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Episode guests

Kraftin Schreyer

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Episode notes

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Quick takeaways

Proactive management strategies, such as expediting patient admissions and enhancing collaboration with inpatient services, are crucial to preventing Emergency Department crowding.

Leadership support from the C-suite is essential for implementing effective solutions to address the challenges of boarding and crowding in Emergency Departments.

Deep dives

Understanding ED Crowding and Boarding

ED crowding occurs when the demand for emergency services surpasses available resources, leading to a situation where patients cannot be seen in a timely manner. Boarding, which is the additional time admitted patients spend waiting in the ED for inpatient beds, directly exacerbates experiencing crowding. The relationship between boarding and crowding is critical, as increased boarding times mean fewer available beds for new patients, further intensifying the crowding problem. A study highlighted during the discussion indicates that during high occupancy periods, median boarding times in the ED significantly increase, demonstrating the urgent need for effective management strategies.

Intro

2min

Tackling ED Overcrowding and Boarding

18min

Understanding Emergency Department Crowding Metrics

3min

Strategies to Address ED Crowding and Improve Patient Flow

4min

Navigating ED Crowding and Boarding Challenges

6min

In this podcast we review both boarding and crowding, the twin kiss of death for an Emergency Department, with Dr. Kraftin Schreyer, an Emergency Medicine physician and ED Administrative Fellowship Director. We discuss boarding and how it can be prevented through surge planning, C-suite buy-in, and cooperation between the in-patient and ED. We then go on to talk about crowding and how it is often a kindred spirit of boarding, but can also exist independently. We discuss options for combating this crowding as well.

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(https://simkit.co/podcast/)