Objective. The boarding of patients in Emergency Department (ED) hallways when no inpatient beds are available is a major cause of ED crowding. One solution is to board admitted patients in an inpatient rather than ED hallway. We surveyed patients to determine their preference and correlated their responses to real-time National Emergency Department Overcrowding Score (NEDOCS). Methods. This was a survey of admitted patients in the ED of an urban university level I trauma center serving a community of 5 million about their personal preferences regarding boarding. Real-time NEDOCS was calculated at the time each survey was conducted. Results. 99 total surveys were completed during October 2010, 42 (42%) patients preferred to be boarded in an inpatient hallway, 33 (33%) preferred the ED hallway, and 24 (24%) had no preference. Mean (±SD) NEDOCS (range 0–200) was for patients preferring inpatient boarding, for ED boarding, and without preference. Male patients preferred inpatient hallway boarding significantly more than females. Preference for inpatient boarding was associated with a significantly higher NEDOCS. Conclusions. In this survey study, patients prefer inpatient hallway boarding when the hospital is at or above capacity. Males prefer inpatient hallway boarding more than females. The preference for inpatient hallway boarding increases as the ED becomes more crowded. 1. Introduction Emergency Department (ED) crowding, or access block, remains a serious problem worldwide, and its causes are multifactorial [1]. One major problem contributing to ED crowding is lack of inpatient beds and boarding of admitted patients in the ED. This obviates the ability to see new patients in the ED, increases wait and length of stay time, and leads to patient and staff dissatisfaction [2]. Emergency Department boarding also compromises patient safety, as ED physicians and nurses must care for these admitted patients while attending to acutely ill and injured patients in the ED under suboptimal conditions [3–5]. One solution to the problem of boarding patients in the ED is the Full Capacity Protocol developed by Viccellio and colleagues at Stony Brook University Hospital in New York [2, 6]. This protocol mandates the boarding of patients in inpatient hallways (IH) during periods of ED crowding and has been successfully implemented in several hospitals in the United States and Canada [6, 7]. We surveyed ED patients who were admitted and awaiting an inpatient bed about their preferences on boarding in IH, ED hallways (EDH), or having no preference (NP), and correlated
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