A retrospective quality improvement study evaluated a multidisciplinary rapid response team (RRT) intervention on ED boarding at a 1,058-bed tertiary hospital in New Taipei City during Taiwan's 2021 COVID-19 surge (43,368 ED visits). The RRT used three strategies: telemedicine diversion of mild cases to quarantine centers, real-time BI dashboard bed monitoring, and an ED-based outpatient parenteral antimicrobial therapy (OPAT) program.
Median ED boarding time dropped from 58.4 h (IQR 42.2–76.8) before the RRT to 6.2 h (IQR 4.1–11.5) after implementation (P < .001). The share of patients boarding >48 h fell from 5.09% in June to 0.16% by December 2021.
Retrospective, single-center design at a newly established hospital limits generalizability. No control group; secular trends (e.g., natural pandemic waning) cannot be fully excluded. The Taiwan context—quarantine infrastructure, telemedicine capacity—may not translate directly to other health systems.
During surge conditions, combining telemedicine-based community diversion, real-time digital bed monitoring, and ED-based OPAT can dramatically cut boarding times. Hospitals preparing for future epidemic surges should consider building these three operational levers before the next crisis hits.
