Emergency department crowding: time for interventions and policy evaluations.

Adrian Boyle,Ian Higginson,Paul Atkinson,Kathleen Beniuk

doi:10.1155/2012/838610

Abstract

This paper summarises the consequences of emergency department crowding. It provides a comparison of the scales used to measure emergency department crowding. We discuss the multiple causes of crowding and present an up-to-date literature review of the interventions that reduce the adverse consequences of crowding. We consider interventions at the level of an individual hospital and a policy level.

Highlights

IntroductionIt has been proposed that emergency department crowding is the equilibrium state of the current health care system [1]
Emergency department crowding is one of the leading problems facing emergency physicians, nurses, and their patients, in most developed countries
It has been proposed that emergency department crowding is the equilibrium state of the current health care system [1]

Summary

Introduction

It has been proposed that emergency department crowding is the equilibrium state of the current health care system [1]. While this may be so, it is not safe; there is a large body of evidence that patients are harmed in crowded emergency departments [2]. Studies have shown that frail, elderly patients and critically ill patients are more likely to spend disproportionate time boarding in the emergency department. Patients harmed by crowding in an emergency department continue to suffer after they have been admitted. There is some evidence that patients admitted through crowded emergency departments have longer hospital stays [10].

Definition of Crowding

Causes of Crowding

Interventions

Output Solutions

Findings

Conclusions