Who’s Boarding in the Psychiatric Emergency Service?
Introduction: When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2014-09-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | http://escholarship.org/uc/item/44d8x30t |
| _version_ | 1818550193177493504 |
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| author | Scott A. Simpson Jutta M. Joesch Imara I. West Jagoda Pasic |
| author_facet | Scott A. Simpson Jutta M. Joesch Imara I. West Jagoda Pasic |
| author_sort | Scott A. Simpson |
| collection | DOAJ |
| description | Introduction: When a psychiatric patient in the emergency department requires inpatient admission,
but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES) has
been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics
of adult PES boarders have not been described.
Methods: We electronically extracted electronic medical records for adult patients presenting to the
PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s
t-tests and multivariate regression.
Results: 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding
encounters, boarding patient encounters were associated with diagnoses of a primary psychotic,
anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to
be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/
seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to
present to the PES on the weekend. Substance use was common, but only tobacco use was more
likely associated with boarding status in multivariate analysis.
Conclusion: Boarding is common in the PES, and boarders have substantial psychiatric morbidity
requiring treatment during extended PES stays. We question the appropriateness of PES boarding
for seriously ill psychiatric patients. [West J Emerg Med. 2014;15(6):669-674] |
| first_indexed | 2024-12-12T08:43:11Z |
| format | Article |
| id | doaj.art-3d5ade7b31e24ac9b15a257e20ecef58 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-12T08:43:11Z |
| publishDate | 2014-09-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-3d5ade7b31e24ac9b15a257e20ecef582022-12-22T00:30:41ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182014-09-0115666967410.5811/westjem.2014.5.20894Who’s Boarding in the Psychiatric Emergency Service?Scott A. Simpson0Jutta M. Joesch1Imara I. West2Jagoda Pasic3University of Colorado School of Medicine, Department of Psychiatry, Denver, ColoradoUniversity of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WashingtonUniversity of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WashingtonUniversity of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WashingtonIntroduction: When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. Methods: We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression. Results: 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/ seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Conclusion: Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. [West J Emerg Med. 2014;15(6):669-674]http://escholarship.org/uc/item/44d8x30t |
| spellingShingle | Scott A. Simpson Jutta M. Joesch Imara I. West Jagoda Pasic Who’s Boarding in the Psychiatric Emergency Service? Western Journal of Emergency Medicine |
| title | Who’s Boarding in the Psychiatric Emergency Service? |
| title_full | Who’s Boarding in the Psychiatric Emergency Service? |
| title_fullStr | Who’s Boarding in the Psychiatric Emergency Service? |
| title_full_unstemmed | Who’s Boarding in the Psychiatric Emergency Service? |
| title_short | Who’s Boarding in the Psychiatric Emergency Service? |
| title_sort | who s boarding in the psychiatric emergency service |
| url | http://escholarship.org/uc/item/44d8x30t |
| work_keys_str_mv | AT scottasimpson whosboardinginthepsychiatricemergencyservice AT juttamjoesch whosboardinginthepsychiatricemergencyservice AT imaraiwest whosboardinginthepsychiatricemergencyservice AT jagodapasic whosboardinginthepsychiatricemergencyservice |