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Access block experienced by a general internal medicine population: factors and outcomes Open Access


Other title
emergency department wait times
emergency department overcrowding
access block
general internal medicine
Type of item
Degree grantor
University of Alberta
Author or creator
Wolodko, Lesley
Supervisor and department
Hegadoren, Kathy (Faculty of Nursing)
Examining committee member and department
Johnston, Curtis (Faculty of Medicine)
Norris, Colleen (Faculty of Nursing)
Faculty of Nursing

Date accepted
Graduation date
Master of Nursing
Degree level
This retrospective study examines the frequency and intensity of access block experienced by a general internal medicine population within a large tertiary care center. The study demonstrated internal medicine admissions experienced significant emergency department wait times and access block. Factors significantly associated with prolonged emergency department times included age, isolation, admission day, admission in fall, admission year, medicine blocked beds, medicine occupancy, medicine emergency inpatients, hospital blocked beds and hospital full capacity stretchers in use. Admission diagnoses of pneumonia and delirium were associated with emergency department length of stay only, while daily number of internal medicine admissions and admission shift was associated with BWT only. Mortality, intensive care unit transfers and inpatient length of stay were not associated with prolonged wait times. Overall general internal medicine patients experienced significant access block. Isolation exerted the most influence on prolonging wait times. Capacity factors did not exert as much influence as anticipated, possibly due to very high occupancy rates.
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