INTERVIEW: ER Congestion, state tries to curtail "boarding”

By Ryan Nobles - bio | email
Posted by Terry Alexander - email

RICHMOND, VA (WWBT) – It has probably happened to you before…a long wait in the emergency room. It is an uncomfortable and annoying experience and one the state and local hospitals are trying to cut down on.

Joining me to discuss the issue is Doctor Tamera Barnes from the Virginia College of Emergency Physicians.

Ryan Nobles: Thank you for being here, Dr. Barnes.

Tamera Barnes: Thank you.

Ryan Nobles: Overcrowding in ERs usually is the result of a practice called boarding. Explain to us what that is.

Tamera Barnes: Boarding is when a patient comes in to the emergency department and the physician determines that the patient needs to be admitted. But there are no rooms in the hospital for the patient to go to. The hospital may be full or there may not be an appropriate bed for the patient to go to. So it's an in-patient who's boarding in the emergency department.

Ryan Nobles: So they sit in a room in the emergency room and then that creates an overcrowded situation because everybody in the waiting room can't be brought in to be seen, correct?

Tamera Barnes: Exactly and we don't want our patients waiting in the emergency department unnecessarily.

Ryan Nobles: And that becomes a real problem because people come to the emergency room, assuming, because they have an emergency, correct? How do we get around this problem of boarding and getting people in to see doctors quicker when they go to the emergency room?

Tamera Barnes: Once it's determined you need to be admitted we want those patients to go upstairs as quickly as possible, so we want to make places available so the new patients can come in. We're trying with this document to try and find a way to solve that problem.

Ryan Nobles: And does it seem as though hospitals and the people you're working with are receptive to this idea? Does it mean increased costs for local hospitals?

Tamera Barnes: No, it's just a matter of trying to use your space efficiently. Right now we often board patients in a hallway in the emergency department and this is not always the most comfortable place. It can be loud, it can be uncomfortable. Lots of new patients coming in, and we're just saying there may be other places like a Post Anesthetic Care Unit where you can take patients who need to be boarded or an in-patient hallway so you can kind of spread the workload around and instead of one department handling all the extra patients like the emergency department, let floors upstairs take some of the extra patients as well.

Ryan Nobles: Quickly, last question for you; is there any role that patient play in making process of overcrowding ERs any better?

Tamera Barnes: Just knowing when it is appropriate to go. I think a lot of people think that there are patients in the emergency department who don't need to be there. Studies don't show that. 90% of our patients really do have emergencies and urgent situations that need our care.

Ryan Nobles: Thank you so much for being here, Dr. Barnes. We appreciate it.

Tamera Barnes: Thank you. 

See the video at right for the full interview.

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