Emergency departments and crowding in United States teaching hospitals

Andrulis, Dennis P.; Kellermann, Arthur L.; Hintz, Elizabeth A.; Hackman, Béla B.; Weslowski, Virginia Beers

doi:10.1016/s0196-0644(05)82976-2

Cited by 217 publications

(117 citation statements)

References 2 publications

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“…11 The following year, in a survey of US teaching hospitals, Andrulis and colleagues determined that 38% of 277 responding institutions reported that overcrowding sometimes forced them to hold admitted patients in the ED for 24 hours or longer. 12 In response to growing concern by its members, ACEP convened a national task force whose recommendations were published in 1990. 13 In recent years, ED overcrowding has become a major This article has been peer reviewed.…”

Section: Scope Of the Problemmentioning

confidence: 99%

No room at the inn: overcrowding in Ontario’s emergency departments

Drummond

2002

CJEM

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Section: Scope Of the Problemmentioning

confidence: 99%

No room at the inn: overcrowding in Ontario’s emergency departments

Drummond

2002

CJEM

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“…Bunun dışında acil olmayan ve basit-hafif şikayetleri olan hastalar da sıklıkla acil servisi tercih etmektedirler (3). Uygun olmayan hastaların acil servise gelmeleri hastanelerde aşırı hasta yoğunluğuna, buna bağlı olarak sağlık hizmetlerinin yürütülmesinde ciddi sorunlara yol açmaktadır (1,(3)(4)(5). Bu aşırı yoğunluk, hastaların uzun süre beklemesine, gerçek acil ve ciddi hastalığı olanlara hizmet verilmesinde gecikmeye, acilde hasta memnuniyetsizliğinin artmasına, hasta tedavilerinin maliyetlerinin artmasına, düşük hizmet kalitesine, güvenlikte ciddi problemlere ve acilde çalışan personelde verim düşüklüğüne yol açmaktadır (3)(4)(5)(6)(7).…”

Section: Introductionunclassified

Admission appropriateness and profile of the patients attended to a state hospital emergency department

Köse¹,

Köse²,

Öncü³

et al. 2011

Gaziantep Med J

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“…Studies typically report the key indicator of ED overcrowding to be the number of admitted patients occupying beds in the ED while they wait for an inpatient bed to become available, otherwise known as inpatient "boarders." [1][2][3][4][5][6] It is also widely acknowledged that for most hospitals, inpatient boarding is a symptom of an underlying hospitalwide problem: an imbalance between the demand and supply of hospital resources. 7,8 Accordingly, studies have focused on inpatient supply-related issues, including staffing levels, bed capacity and bed use by patients who no longer require acute care.…”

Section: Introductionmentioning

confidence: 99%

Understanding hospital and emergency department congestion: an examination of inpatient admission trends and bed resources

Wong

Morra

Caesar

et al. 2010

CJEM

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Objective: Patients in the emergency department (ED) who have been admitted to hospital (inpatient "boarders") are associated with ED overcrowding. They are also a symptom of a hospital-wide imbalance between demand and supply of resources. We analyzed the trends of inpatient admissions, ED boarding volumes, lengths of stay and bed resources of 3 major admitting services at our teaching institution. Methods: We used hospital databases from Jan. 1, 20041, , to Dec. 31, 2007, to analyze ED visits that resulted in admission to hospital. Results: During the study period, 21 986 ED patients were admitted to hospital. The percentage of cancer-related admissions to the oncology admitting service decreased from 48% in 2004 to 24% in 2007, and admissions to general internal medicine (GIM) increased nearly 2-fold, from 28% in 2004 to 54% in 2007. In addition, GIM admitted about 10% more myocardial infarction and heart failure patients than did cardiology. General internal medicine constituted the majority of ED boarders and had a median boarding length of stay of approximately 15 hours. Inpatient beds on oncology and cardiology services remained static. Conclusion: Without bed capacity to admit more patients, our specialty services relied on GIM to serve as a safety net. At the same time, GIM was cited as a main source of ED congestion as their patients occupied more ED beds for longer periods than any other admitting service. The data presented in this study has helped effect positive change within our institution. Other hospitals running at or near capacity and faced with similar ED congestion may apply the methods we used in this study to analyze the cause and nature of their situation.

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Emergency departments and crowding in United States teaching hospitals

Cited by 217 publications

References 2 publications

No room at the inn: overcrowding in Ontario’s emergency departments

No room at the inn: overcrowding in Ontario’s emergency departments

Admission appropriateness and profile of the patients attended to a state hospital emergency department

Understanding hospital and emergency department congestion: an examination of inpatient admission trends and bed resources

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