How to Address the Rising Problem of Emergency Department Overcrowding




Wright, Michael

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Across the country, emergency departments (EDs) are facing increases in the number of patients they see, overcrowding, lengths of stay, and worsening outcomes. In 2016, the CDC reported that there were 45.8 visits to EDs per 100 people, with less than half of patients being seen in under 15 minutes. ED patient volumes rise each year while no significant progress has been made in improving the operational process. This study aims to better understand the root of the problem that afflicts emergency departments by first evaluating the efficacy of current process-improvement interventions, and to then suggest possible ways to combine these strategies in order to yield even greater results. To do this, I conducted a systematic literature review to compile studies that are specific to the five process-improvement strategies so that they may each be thoroughly analyzed. Initial findings indicate that the Fast-Track Units and Physician-in-Triage strategies have had the most consistent success in improving patient wait times and emergency department overcrowding. However, the other strategies have significant benefits in other facets of the emergency process that require further consideration. Additionally, some of the strategies are able to be combined and require future research to discern their additive effects. Understanding the factors that ultimately create slow downs and bottlenecks in emergency departments opens up new ways to better patient care and without interventions to address these issues, both the patients and the hospital will face even worse outcomes.


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