New Study: EDs Need to Step Up Their Game to Stem Overcrowding

There are new data supporting the belief that emergency rooms are not doing enough to stem overcrowding—a longstanding rationale for visiting an urgent care center for nonemergent complaints. A new study published in Health Affairs says that while more hospitals are adopting interventions to prevent overcrowding (eg, bedside registration, scheduling elective surgeries on weekends), far too many are not doing enough. Researchers from Albany Medical College, George Washington University, and Harvard Medical School report that 19 percent of the hospitals in the most crowded quartile are still not doing bedside registration. Less than half of 17 interventions studied saw a significant increase in adoption. In addition, only 38 percent of the most crowded hospitals studied have full-capacity protocols that would allow a patient to be moved to an alternate area of the hospital while ED beds are full. EDs in areas that are rich in uninsured patients are most likely to see the most traffic related to nonemergent symptoms. One frequent cause of overcrowding is “boarding” patients in the ED, a practice intended to move them more quickly from the ED to being admitted; overcrowding results when nonemergent patients get piled into an area that is already backed up.