ER overcrowding: Busiest departments don't adopt effective strategies

Emergency department overcrowding remains a major problem throughout the country, but a new study finds that hospitals with the busiest emergency rooms haven't adopted proven interventions that could alleviate the stress.

The study, published in Health Affairs, found that the problem with overcrowding in the ED increased between 2007 and 2010. But 19 percent of the nation's most crowded EDs have not implemented bedside registration. More distressingly, the researchers found, 94 percent have not adopted surgical schedule "smoothing," a process that aligns surgical procedure schedules and inpatient bed availability.  

The data indicate that, even as ED overcrowding worsens, many providers consider it a secondary priority, lead author Leah S. Honigman Warner, M.D., said in a statement. "With implementation of the Affordable Care Act and pressure to reduce healthcare costs, crowding will likely continue to worsen," she said. "We know there are effective interventions that can mitigate crowding, now is the time to develop best practices to reduce emergency department crowding so that we can provide the highest-quality patient care."

The problem of overcrowding is linked to worse patient care and worse outcomes, including higher mortality rates, higher rates of complications and errors, according to Jesse M. Pines, director of the Office for Clinical Practice Innovation, professor of emergency medicine and health policy at the GW School of Medicine and Health Sciences.

Some steps that hospitals have taken to alleviate ED overcrowding include increasing specialization to ease the transfer process and developing a profile of the patient population that contributes to overcrowding.

To learn more:
- read the study abstract
- here's the announcement