611 - Reducing Average Admission Boarding Time From Pediatric Emergency Department To Pediatric Inpatient Unit At King’s County Hospital: A Multidisciplinary QI Project

Publication Number: 2596.611

Nana Ama Owusua. Owusu, SUNY Downstate Health Sciences College of Medicine, Brookyln, NY, United States; sweta dubey, SUNY Downstate Health Sciences University, New York, NY, United States; Sowmya shashidhara, Suny downstate medical center, Brooklyn, NY, United States; Sai Sravya gude, State University of New York Downstate Medical Center College of Medicine, Brooklyn, NY, United States; Amna Mubarik Ali, Suny Downstate University Hospital, NY, NY, United States; Jonelle J. Ramsarran, State University of New York Downstate Medical Center College of Medicine, Brooklyn, NY, United States; Saema H. Khandakar, NYC Health + Hospitals/Kings County, Albertson, NY, United States; Ratna B. Basak, Kings County hospital, greenvale, NY, United States

Background: Admission Boarding Time (ABT) is the interval between the emergency department (ED) physician’s decision to admit a patient and the patient’s arrival at the inpatient unit (IPU). Admission boarding time has become a critical public health issue in the United States, demanding urgent attention. Recent studies continue to highlight its detrimental effects on patient outcomes and negative impact on the mental health and well-being of healthcare staff. In addition, it reduces the public’s access to timely emergency services and increases healthcare costs. Pediatric emergency departments (EDs) have similarly experienced increasing ABTs

Objective: This project aims to reduce average pediatric ABT at Kings County Hospital from 248 minutes to 120 minutes, i.e 51% reduction, in a 6-month period.

Design/Methods: We used the EPIC slicer-dicer tool to collect daily ABT data between November 2024 and October 2025. Using the daily ABT data, we derived the average monthly ABT. Statistical analyses were performed using appropriate quantitative methods (means, t-tests) to identify significant correlations and assess the impact of these interventions on the PED department’s boarding times. The project proposal was reviewed and exempted by the Institutional Review Board at the start of the project.

Results: Before April 2025, the monthly mean ABT fluctuated between 237.85 and 245.8 minutes. Following the introduction of early discharge measures—such as educating inpatient teams and planning discharges the night before—implemented in April 2025, we noted a 51% decrease (from 183.43 to 89.67 minutes, p < 0.01) in the mean ABT in the subsequent month. Additionally, the implementation of a protocol promoting the judicious use of monitored beds on the inpatient floor in June 2025, also resulted in a 13% reduction in average ABT (from 117.5 to 101.78 minutes, p < 0.01) in the following month.

Conclusion(s): The project demonstrates the impact of targeted cost-effective interventions, specifically, optimizing the use of monitored beds and the planning of early discharges, on reducing pediatric admission boarding times. A multidisciplinary approach, including interventions such as judicious use of monitored beds and early discharges, is needed to address the issue of prolonged ABT.