4 strategies to reduce ER overcrowding

Overcrowded emergency rooms are common in hospitals across the country. But several key strategies unite the facilities that are most effectively tackling this problem, according to a new study.

Researchers stratified hospitals into three groups based on data from the Centers for Medicare & Medicaid Services: highest-performing, high-performing and low-performing, according to the Annals of Emergency Medicine study.

They chose a representative sample of 12 hospitals, four from each group, and interviewed 60 leaders across those hospitals to determine what was working to reduce overcrowding.

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Four strategies, which could be replicated in other hospitals, were identified:

  1. Executive buy-in: Leaders in the highest-performing hospitals had identified overcrowding as a key problem for them to solve, setting goals and providing the resources to accomplish them.
  2. Responses coordinated across the hospital: Hospitals in the low-performance group often operated in silos, while the highest-performing deployed strategies that required coordination between departments.
  3. Use of data: High-performing hospitals gathered and leveraged data to adjust ER operations in real time and to provide feedback to key staff members. Predictive analytics allowed ER staff to map needs and estimate patient flow.
  4. Accountability: The highest-performing hospitals addressed issues immediately and held staff members accountable.

Benjamin Sun, M.D., a professor of emergency medicine at Oregon Health & Science University and the study’s senior author, said in an announcement that overcrowded ERs can be dangerous for patients, so finding a solution to the issue is crucial.

“Emergency department crowding can be dangerous for patients,” he said. “We know, for example, that emergency department crowding can lead to delays in pain medications for patients with broken bones, as well as delays in antibiotics for patients with pneumonia. We know the risk of death is higher when the emergency department is more crowded than when it’s less crowded.”

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Hospitals have deployed a number of programs aimed at reducing overcrowding in the emergency department. Baptist Health South Florida, for instance, introduced “tele-triage” to address patients with minor injuries or other common, but not urgent, maladies.

Others have hired “bed czars” to monitor flow in the ED or have launched fast-track programs to speed up treatment for patients with minor needs.