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ED boarding and overcrowding

Emergency department (ED) visits to hospitals continue to rise. In a 2010 survey by the American Hospital Association, 38 percent of respndents indicated that their ED was operating “at” or “over” capacity. According to a recent study by the Schumacher Group, 66 percent of the hospital emergency department administrators surveyed predicted that the implementation of health reform will increase patient volume at their EDs. Capacity issues often result in overcrowding or boarding of ED patients.

What is the solution? Here are a few recommendations:

Alakeson, V., Pande, N., and Ludwig, M. A plan to reduce emergency room “boarding” of psychiatric patients. Health Affairs. 29(9):1637-42, Sept. 2010.  http://content.healthaffairs.org/content/29/9/1637.abstract

American College of Emergency Physicians. Emergency Department Crowding: High-Impact Solutions. Apr. 2008. http://www.acep.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=50026&libID=50056

Carrus, B., Corbett, S., and Khandelwal, D. A hospital-wide strategy for fixing ED overcrowding. McKinsey Quarterly. Jan. 2010.  https://www.mckinseyquarterly.com/A_hospital-wide_strategy_for_fixing_ED_overcrowding_2505

Rapid Admission Protocol for Emergency Department Patients Reduces Boarding Time. AHRQ Health Care Innovations Exchange. Dec. 29, 2010. http://www.innovations.ahrq.gov/content.aspx?id=2926

Wiler, J. L., and others. Optimizing emergency department front-end operations. Annals of Emergency Medicine. 55(2):142-160, Feb. 2010. http://www.acep.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=48765&libID=48794

For more articles on this topic, click here.




2010 Survey of Hospital Emergency Department Administrators. Lafayette, LA: The Schumacher Group, 2010. http://schumachergroup.com/_uploads/news/pdfs/ED%20Challenges%20and%20Trends%2012.14.10.pdf

Chartbook. Trends Affecting Hospitals and Health  Systems. Chapter 3: Utilization and Volume. Chicago: American Hospital Association, 2010. http://www.aha.org/aha/research-and-trends/chartbook/ch3.html

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