Increased Length of Stay in the Emergency Department and Psychiatric Patient Outcomes – A Literature Review

RM 211

There has been an increase in boarding time among psychiatric patients in the Emergency Department (ED). Research indicates that psychiatric patients wait 1089 minutes to receive specialized care compared to 340 minutes for nonpsychiatric patients. Yet, there is a paucity of research on contributing factors related to poor health outcomes that are affected by prolonged length of stay (LOS). Objective: The objective of this systematic literature review is to investigate the contributing factors that lead to poor outcomes among adult psychiatric patients boarding the ED. Methodology: Using a systematic approach, the databases utilized included EBSCOhost Academic Search Premier, ScienceDirect, PubMed (MEDLINE), PsycARTICLES, PsycINFO and Current Index to Nursing and Allied Health Literature (CINAHL), which allowed redirection to other search engines like Wiley Online Library and SAGE Journals Online. Frequently used keywords: emergency department, psychiatric, boarding, length of stay, and poor outcomes. Inclusion: peer-reviewed articles published in English. Results: Utilizing 25 articles, our research team investigated factors that may contribute to poor health outcomes for psychiatric patients who experience a prolonged LOS in the ED. Some of these factors include lack of specialized medication, loss of sufficient sleep, loss of specialized care, lack of support, loss of privacy and loss of autonomy. Conclusion: Given the national awareness of mental health and based on our findings, we see opportunities to address this pressing issue such as increased funding to mental health research, improvement projects, and implementation of legislative policies that ensure that psychiatric patients do not experience an unacceptable LOS.