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Hall Health Emergence

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The Associated Press

Published: October 27, 2008

CHICAGO - There's no phone and no television. Only a screen offers privacy. But heart patient Edward Gray understands why the hospital put him in a cardiac unit hallway.

"They sent me up here to make room for other emergency patients," Gray, 78, said last week from his bed in the hall of a New York area hospital. "This is the way things are in hospitals."

It may not sound like ideal health care, but hospital officials nationwide are being urged to consider hallway medicine as a way to ease emergency department crowding, and some are trying it.

Leading the way is Stony Brook University Medical Center at Stony Brook, N.Y., where a study found that no harm was caused by moving emergency room patients to upper-floor hallways when they were ready for admission.

The study's lead author says all hospitals should look at the program's success.

"This is yet another battle cry for hospitals to get off their duffs and stop stacking people knee-deep in the emergency department," said Peter Viccellio, clinical director of the hospital's emergency department. He is to present the study's findings Tuesday at a meeting of the American College of Emergency Physicians in Chicago.

Before the change, when his hospital filled up, patients were admitted but held in the ER in a common practice called boarding. On busy days, "things would grind to a halt and people would wait to be seen," Viccellio said.

Holding patients in ERs can cause deaths, doctors say. In a 2007 survey of nearly 1,500 emergency doctors, 13 percent said they personally experienced a patient dying as a result of boarding in the emergency department. The survey was conducted by the American College of Emergency Physicians.

The new study found slightly fewer deaths and intensive care unit admissions in the hallway patients compared with the standard bed patients. That was no surprise, Viccellio said, because the protocol calls for giving the first available rooms to the sickest patients. Intensive care patients never go to hallways.

The study is based on four years of Stony Brook's experience with more than 2,000 patients admitted to hallways from the ER.

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