Emergency Department Overcrowding: The Impact of Resource Scarcity on Physician Job Satisfaction

Rondeau, Kent V.; Francescutti, Louis Hugo

doi:10.1097/00115514-200509000-00009

Cited by 85 publications

(57 citation statements)

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“…This view stems, in part, from the perception that PHM may increase crowding in the emergency departments. Overcrowding and resource scarcity have become key barriers to patients receiving timely care (24)(25)(26). Although ambulance diversion systems are typically used to manage ambulance traffic during periods of overcrowding, the resulting increased travel distance to the next closest hospital inevitably results in treatment delay (27,28).…”

Section: Discussionmentioning

confidence: 99%

Evaluating the views of paramedics, cardiologists, emergency department physicians and nurses on advanced prehospital management of acute ST elevation myocardial infarction

Rajabali

Tsuyuki

Sookram

et al. 2009

Canadian Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Evaluating the views of paramedics, cardiologists, emergency department physicians and nurses on advanced prehospital management of acute ST elevation myocardial infarction

Rajabali

Tsuyuki

Sookram

et al. 2009

Canadian Journal of Cardiology

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“…[1][2][3] Researchers have identified delays in transferring admitted patients to inpatient wards from the ED (access block) as the leading determinant of ambulance diversion and ED overcrowding; however, there are other contributing factors, including a steady increase in patient visits, inadequate access to primary health care, and failure to train and retain ED staff to cope with increasing volumes. 4,5 Pediatric emergency departments (PEDs) have also been strained with overcrowding.…”

Section: Abstract: Patient Flow Pediatric Emergency Departments Usementioning

confidence: 99%

Trends in use in a Canadian pediatric emergency department

Doan¹,

Genuis²,

2014

CJEM

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Introduction: Emergency department (ED) crowding is a significant problem in Canada and has been associated with decreased quality of care in general and pediatric emergency departments (PEDs). Although boarding of admitted patients in the ED is the main contributor to adult ED overcrowding, factors involved in PED crowding may be different. The objective of this study was to report the trend in PED services use and to document the degree of overcrowding experienced in a Canadian PED. Methods: A retrospective cohort study was conducted using administrative data from a tertiary care PED from 2002 to 2011. The primary outcome was PED use (total volume of visits and case severity per triage levels using the Canadian Triage and Acuity Scale [CTAS] score and admissions). Secondary outcomes included measures of PED overcrowding, such as rates of patients leaving without being seen (LWBS) and length of stay (LOS).Results: Total volumes increased by 30% over the 10-year study period, whereas hospitalizations remained stable at approximately 10%. Trends in CTAS levels did not indicate meaningful changes in the severity of cases treated at our PED. LWBS proportions among CTAS 3, CTAS 4, and CTAS 5 groups and LOS for all CTAS groups progressively and statistically increased from year to year. Conclusions: Over the course of the study period, there was a substantial increase in PED visits, which likely contributed to the worsening markers of PED flow outcomes. Further study into the effects of PED crowding on patient outcomes is warranted.

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“…Overcrowding also diminishes the ability of the ED to provide immediate access and stabilization to those patients who have an urgent medical condition [4,5] . Excessive patient overload also leads to decreased physician productivity [6][7][8] . Long ED holds across hospitals in the United States are proven to be decidedly correlated to higher patient length of stay (LOS) on inpatient care units [1,9,10] .…”

Section: Introductionmentioning

confidence: 99%

A modular simulation study to improve patient flow to inpatient units in the emergency department

Norouzzadeh

Garber

Longacre

et al. 2014

JHA

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In this study, a modular discrete event simulation (computer modeling) has been presented to support process improvements in a hospital's emergency department (ED) to streamline admitted patient flow to inpatient units. Because the ED in this study has less than 10 beds, unnecessary occupation of beds affects the patient wait time dramatically. Additionally, ED overcrowding diminishes the quality of care, increases costs, and decreases employee and patient satisfaction. The modular simulation model evaluated the effectiveness of several recommended workflow improvements, resulting from comprehensive statistical analysis, based on their impact on cycle time and time traps in the process. The results suggested that, to ensure better efficiency and optimal cycle time, all of the suggested workflow improvements should be implemented simultaneously. The model also suggested that achieving customer satisfaction is possible 96.26% of the time with the current resource allocations in the ED.

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Emergency Department Overcrowding: The Impact of Resource Scarcity on Physician Job Satisfaction

Cited by 85 publications

References 0 publications

Evaluating the views of paramedics, cardiologists, emergency department physicians and nurses on advanced prehospital management of acute ST elevation myocardial infarction

Evaluating the views of paramedics, cardiologists, emergency department physicians and nurses on advanced prehospital management of acute ST elevation myocardial infarction

Trends in use in a Canadian pediatric emergency department

A modular simulation study to improve patient flow to inpatient units in the emergency department

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