Emergency Department Crowding: Time for Interventions and Policy Evaluations

Boyle, Adrian; Beniuk, Kathleen; Higginson, Ian; Atkinson, Paul

doi:10.1155/2012/838610

Cited by 147 publications

(119 citation statements)

References 37 publications

(31 reference statements)

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“…Several professional societies including Society of Academic Emergency Medicine (SAEM), American College of Emergency Physicians (ACEP), American Academy of Emergency Physicians (AAEM), Emergency Nurses Association (ENA), College of Emergency Medicine (CEM), Australasian College of Emergency Medicine (ACEM), Canadian Association of Emergency Physicians (CAEP), and the Institute of Medicine (IOM) have published proposals to reduce or end ED crowding [50][51][52][53][54][55][56][57]. The prospect of reducing ED crowding in the near future may be elusive, as many EDs have made major attempts for the past two decades with minimal or no improvement [58,59]. Simply building a larger ED to increase capacitance may not solve the problem, as the chief reason for overcrowding is "exit block, " or the impaired ability to move patients out of the ED [60,61].…”

Section: Solutions To Hallway Carementioning

confidence: 99%

Providing Care in Emergency Department Hallways: Demands, Dangers, and Deaths

Richards

Linden

Derlet

2014

Advances in Emergency Medicine

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Emergency departments (ED) worldwide have experienced dramatic increases in crowding over the past 20 years that now have reached critical levels. One consequence of ED crowding has been the routine use of ED hallways for patient care. This includes ED patients who are awaiting care but are considered unstable to remain in the waiting room, patients who are undergoing active medical and trauma treatment, and patients who have been stabilized but await transfer to an inpatient bed (boarding) or another institution. Compared with licensed hospital or standard ED beds, care in ED hallways results in increased patient morbidity and mortality, as well as patient and staff dissatisfaction. Complications experienced by hallway patients include unrecognized sudden respiratory arrest or unstable cardiac arrhythmias, delay in time-sensitive procedures and laboratory testing, delay in receiving important medications, excessive or unrelieved pain, overall increased length of stay, increased disability, and exposure to traumatic psychological events. While much has been published on the general problems of ED crowding, only recently have studies focused exclusively on the issues of providing care in ED hallways. This review summarizes the current issues, challenges, and solutions for hallway care.

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Section: Solutions To Hallway Carementioning

confidence: 99%

Providing Care in Emergency Department Hallways: Demands, Dangers, and Deaths

Richards

Linden

Derlet

2014

Advances in Emergency Medicine

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“…Although some wrote that shortage of hospital beds is the most prominent reason for ED overcrowding [6], we have shown that, without increasing the number of our hospital total number of beds, we managed to render our ED from crowded to non-crowded. New initiatives (e.g.…”

Section: Discussionmentioning

confidence: 78%

From an Overcrowded to a Smoothly Functioning Emergency Department within Two Months

Basis¹

2017

J Gen Pract

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Background: Our Emergency Department (ED) went through two periods with different managers. Although the number of beds, visits and admissions during these two periods didn't change significantly, a change in the ED's policy, without a change in the hospital's policy, converted a very crowded ED to an uncrowded one within few weeks, and changed the pattern of work in the hospital, gradually for many years.

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“…Semakin cepat waktu pasien untuk dipindah ke ruangan semakin cepat pula waktu tunggu pasien setelah keputusan rawat inap diputuskan di IGD zona kuning. Waktu tunggu pasien setelah keputusan rawat inap diputuskan yang direkomendasikan oleh Rumah Sakit dr. Iskak Tulungagung adalah tidak lebih dari 6 jam (Boyle et al, 2012). Hal ini sesuai dengan penelitian yang dilakukan oleh Mulyono (2003) yang menyatakan bahwa proses pengambilan keputusan terkait keputusan medis di Indonesia ditentukan oleh budaya, dimana pengambil keputusan terkait tindakan medis baik dalam hal ini rawat inap adalah anggota keluarga tertua.…”

Section: Pembahasanunclassified

ANALYSIS OF FACTORS ASSOCIATED WITH BOARDING TIME IN YELLOW ZONE OF EMERGENCY DEPARTMENT AT dr.ISKAK TULUNGAGUNG HOSPITAL

Deviantony¹,

Ahsan

Setyoadi

2017

NLJ

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ABSTRAKKunjungan pasien di instalasi gawat darurat (IGD) terus bertambah tiap tahunnya. Peningkatan jumlah kunjungan rumah sakit berbanding lurus dengan peningkatan jumlah pasien yang masuk ke ruang kegawatdaruratan. Jumlah pasien yang meningkat mengakibatkan adanya penumpukan pasien di IGD terutama di zona kuning dan menyebabkan waktu tunggu setelah keputusan rawat inap diputuskan semakin lama. Tujuan penelitian adalah melakukan analisis permasalahan terkait variabel yang memiliki keterikatan dengan waktu tunggu pasien setelah keputusan rawat inap diputuskan di zona kuning instalasi gawat darurat RSUD dr. Iskak Tulungagung. Metode penelitian adalah observasional analitik dengan pendekatan cross sectional. Jumlah sampel 78 responden. Teknik sampling menggunakan non probability sampling. Uji Pearson dan uji Spearman untuk mengetahui hubungan antar variabel dan uji multivariat regresi linier untuk mengetahui faktor yang paling dominan dalam memengaruhi waktu tunggu pasien setelah keputusan rawat inap dibuat. Hasil uji bivariat menunjukkan ada hubungan waktu tunggu pasien setelah keputusan rawat inap dengan waktu persiapan ruangan (p=0,000), hasil uji lab (p=0,000), waktu diagnostik (p=0,000), dan perbandingan perawat dengan pasien (p=0,000). Waktu tunggu pasien tidak ada hubungan dengan waktu kedatangan (p=0,263) dan kepemilikan asuransi (p=0,980). Analisis multivariat dengan regresi linier diperoleh nilai konstanta 681,212, nilai perbandingan perawat dengan pasien (p=0,000; B=-861,011), nilai waktu pemindahan pasien (p=0,000; B=0,620) dan waktu diagnostik (p=0,022; B=2,636) Implikasi penelitian adalah didapatkan konstanta berhubungan dengan boarding time yang mampu memperpendek waktu tunggu pasien setelah keputusan rawat inap dibuat. Saran yang diberikan adalah adanya waktu standar yang bisa dicapai untuk mengurangi waktu boarding pasien. ABSTRACT Patient's visits in the emergency room (ER) increase in number in

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Emergency Department Crowding: Time for Interventions and Policy Evaluations

Cited by 147 publications

References 37 publications

Providing Care in Emergency Department Hallways: Demands, Dangers, and Deaths

Providing Care in Emergency Department Hallways: Demands, Dangers, and Deaths

From an Overcrowded to a Smoothly Functioning Emergency Department within Two Months

ANALYSIS OF FACTORS ASSOCIATED WITH BOARDING TIME IN YELLOW ZONE OF EMERGENCY DEPARTMENT AT dr.ISKAK TULUNGAGUNG HOSPITAL

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