[Adverse moral consequences of overcrowding among emergency department professionals: an explorative survey]

Overcrowding is common in emergency departments (EDs). However, the effects on moral distress among personnel are not well understood. There is a lack of suitable empirical studies, particularly for work in EDs in Germany.

Exploratory investigation into the reported frequency and correlations of adverse moral consequences of overcrowding among ED staff.

Combined survey study of physicians and nurses at an interdisciplinary ED at a university hospital and use of clinical process data. Standardized survey assessed overcrowding, including a list of undesirable moral consequences, as well as sick days and burnout symptoms. Descriptive and correlation analysis of survey data and Community Emergency Department Overcrowding Scale (CEDOCS) data.

The subjectively assessed and objectively collected frequencies of overcrowding were not entirely consistent. The most frequently experienced undesirable moral consequences of overcrowding were prolonged patient stays, higher workloads for staff, and insufficient privacy and care control for patients. This was similar for both professional groups. Correlations with sick days and burnout were inconsistent.

For the first time, undesirable moral consequences associated with ED overcrowding have been empirically identified. The results also provide insights into the methodological challenges that future studies on the subjective consequences of overcrowding for ED personnel should take into consideration.