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Emergency department crowding: old problem, new solutions.

Steven L Bernstein1, Brent R Asplin

  • 1Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA. sbernste@montefiore.org

Emergency Medicine Clinics of North America
|September 20, 2006
PubMed
Summary
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Emergency department (ED) crowding is a growing crisis impacting patient care quality and outcomes. Further research is crucial to understand and address the factors contributing to this nationwide problem.

Area of Science:

  • Health Services Research
  • Public Health
  • Emergency Medicine

Background:

  • Emergency department (ED) crowding is a significant issue in the United States.
  • Multiple factors contribute to crowding, including increased patient volume and reduced ED capacity.
  • Crowding negatively affects care quality, timeliness, and patient outcomes.

Purpose of the Study:

  • To review the contributing factors to ED crowding.
  • To discuss the impact of crowding on patient care and ED operations.
  • To highlight the need for further research and solutions.

Main Methods:

  • Conceptual framework categorizing crowding factors into input, throughput, and output domains.
  • Review of existing measures for quantifying ED crowding.

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  • Identification of research gaps.

    • Main Results:

    • ED crowding stems from issues related to patient input, internal processes (throughput), and patient discharge/transfer (output).
    • Various metrics exist to measure crowding, but understanding its full impact requires more investigation.
    • The problem's complexity necessitates a deeper understanding of its drivers and consequences.

    Conclusions:

    • ED crowding is a multifaceted problem with serious implications for patient safety and healthcare efficiency.
    • Additional research is essential to develop effective strategies for mitigating ED crowding.
    • Addressing this crisis requires a comprehensive approach focusing on input, throughput, and output factors.