Factors associated with exit block, and impact on the emergency department

Exit block occurs when “patients in the ED requiring inpatient care are unable to gain access to appropriate hospital beds within a reasonable time frame”. In the UK, exit block has been defined as occurring when a patient spends “4 hours or more in the ED from arrival to admission, transfer or discharge”. A number of factors contributing to an ED becoming blocked have been identified and include the lack of availability of a hospital bed for admitted patients, long waiting times for diagnostics/test results in the ED, and difficulties in discharging patients to their usual residence or an alternative destination. The CLAHRC research team are exploring whether there are characteristics of NHS acute trusts and Type 1 EDs which are associated with exit block.