Please use this identifier to cite or link to this item: https://hdl.handle.net/1959.11/56301
Title: Hospital Access Block: A Scoping Review
Contributor(s): Clark, Joanne (author); Islam, Md Shahidul  (author)orcid 
Publication Date: 2022-07
Early Online Version: 2022-05-14
DOI: 10.1016/j.jen.2022.03.001
Handle Link: https://hdl.handle.net/1959.11/56301
Abstract: 

Introduction: The overarching objective of this scoping review was to explore the breadth of health care literature in attempts to identify current strategies that hospitals adopt to improve patient bed flow, reduce access and exit block while optimizing patient care.

Methods: PubMed, CINAHL, Embase, Proquest, and Cochrane electronic library databases supported literature search in March 2021. Scholarly articles that met the 3 eligibility criteria—access block causes, effects, and solutions—were considered. Joanna Briggs Institute Guidelines supported first- and second-level literary screening processes.

Results: The synthesis included 43 references. Most initiatives addressed access (n = 15), followed by care (n = 16) and then community (n = 9), with a further 3 articles providing commentary across all 3 domains (n = 3). Evidence supported Lean principles in both emergency department and inpatient sector. Lean principles addressing access included physician-led ED triage models, point-of-care testing, overcapacity protocols, mental health team collocation models, and fast-track services. Inpatient care Lean concepts validated gains in multidisciplinary rounds, appropriate allocation of allied health services with a 7-days-a-week model, staggering of elective surgeries, journey boards usage, transit lounges, and lateral transfers. Most literature addressing the backend was narrative in nature, theorized, and advocating for solutions and policy reform.

Discussion: This study addressed aims and identified current strategies that hospitals adopt to tackle access block while guaranteeing patient care. Government-supported research to map out evidence-based models of care that address exit block and demonstrate efficiencies is required to optimize access to care in the community.

Publication Type: Journal Article
Source of Publication: Journal of Emergency Nursing, 48(4), p. 430-454
Publisher: Elsevier Inc
Place of Publication: United States of America
ISSN: 1527-2966
0099-1767
Fields of Research (FoR) 2020: 420699 Public health not elsewhere classified
429999 Other health sciences not elsewhere classified
420399 Health services and systems not elsewhere classified
Socio-Economic Objective (SEO) 2020: 200499 Public health (excl. specific population health) not elsewhere classified
209999 Other health not elsewhere classified
200399 Provision of health and support services not elsewhere classified
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Health

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