Correlation Between Emergency Department Crowding and Adverse Occurrences in an Academic Hospital: A Retrospective...

Emergency care predominantly involves the treatment of abrupt clinical status deteriorations, illness exacerbation, and potentially life-threatening injuries. However, crowding and excessive delays in the emergency department (ED) affect the quality of care and are associated with undesirable outcomes.

This study aimed to determine the association of emergency department (ED) crowding with patient outcomes at a teaching hospital in Saudi Arabia's Central Province.

Using a retrospective chart review of electronic medical records, we extracted mortality, morbidity, and safety events-related data of all adult, pediatric, and obstetric patients who presented to the King Abdullah Bin Abdulaziz University Hospital (KAAUH) emergency department (ED) between January 2019 and December 2022. Based on the emergency department (ED) census, these data were cross-referenced by date with the emergency department (ED) situation.

Sixty patients had safety events; medication-related safety events were the most prevalent (38%), followed by care-coordination events (30%). Twenty cases of mortality and morbidity were reported. Crowding significantly affected adverse medication-related and care-coordination events (p = 0.0212), with a more significant effect on moderate safety events than on mild safety events (p = 0.0348). Influence of emergency department (ED) crowding (p = 0.3740) was on mortality or morbidity outcomes was detected. The data was extracted from a total of 139176 emergency visits for all categories.

In Saudi Arabia, emergency department (ED) crowding signifies a critical healthcare crisis, potentially compromising quality of care. Our findings provide evidence of increased errors in medication, care coordination, and medical care due to emergency department (ED) crowding. Implementing micro and macro-level strategies to reduce emergency department (ED) crowding could help improve patient outcomes.