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The 'who are all these people?' study
Peadar Gilligan1, Danny Joseph2, Matthew Bartlett2
1Emergency Department, Beaumont Hospital, Dublin, Ireland.
Insights
Emergency department overcrowding is a major issue, with most patients boarded awaiting beds. Understanding who occupies the department, including patients and visitors, is key to implementing effective crowd reduction strategies.
Area of Science:
- Emergency Medicine
- Healthcare Management
Background:
- Emergency department (ED) overcrowding negatively impacts care delivery and increases patient mortality.
- The study ED is consistently among the most overcrowded in Ireland.
Purpose of the Study:
- To identify contributors to ED crowding.
- To specifically analyze the patient-associated population within the ED.
Main Methods:
- Observational study in a consistently overcrowded Irish ED.
- Analysis of patient and staff demographics within the ED during the study period.
Main Results:
- An average of 66.7% of ED occupants were patients awaiting hospital beds.
- The majors area was the most crowded, with patients comprising 55.5% of occupants.
- Visitors, nursing staff, on-call teams, and ED doctors constituted significant portions of the remaining occupants.
Conclusions:
- Identifying the composition of ED occupants informs management decisions for crowd reduction.
- Implementation of a strict visitor policy, limiting numbers and duration, is a strategy to mitigate ED crowding.
Background:
Overcrowding of emergency departments (EDs) adversely affects the delivery of emergency care and results in increased patient mortality.
Objective And Methods:
To examine what contributes to the ED crowd and to specifically examine the patient associated population. The ED in which the research was performed is consistently one of the most overcrowded in Ireland.
Results:
On average 66.7% of the patients in the ED during the study period were boarded awaiting a hospital bed following full processing by the ED staff and agreement by the on-call team that admission was required. The most overcrowded part of the department was the majors area. In this area 55.5% of those present were patients, visitors accounted for 16.6% of occupants, nursing staff 11%, on-call teams 7% and the ED doctors 6.3%.
Conclusions:
Knowing who the people in the crowd are helps to guide management decisions about how the crowd might be reduced. Our department now has a strict accompanying person/visitor policy that limits the number of visitors to patients and limits visiting times for those relatives with a patient who is experiencing a prolonged stay in the ED.
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