Portal de Periódicos da CAPES

The Evolution of ED Crowding

2013; Elsevier BV; Volume: 40; Issue: 2 Linguagem: Inglês

10.1016/j.jen.2013.01.013

1527-2966

Aaron A. Bellow, Gordon Lee Gillespie,

Healthcare Systems and Technology

ED crowding, a condition that occurs when the need for emergency services outstrips the available resources in the emergency department, is a contemporary issue of high importance to ED leaders. 1 American College of Emergency Physicians Emergency department crowding information paper. http://www.acep.org/clinical-practice-management/emergency-department-crowding/ Google Scholar ED crowding has been discussed in the literature for more than 20 years. The phenomenon was first introduced in the late 1980s, but it was not until the early 1990s that professional organizations such as the American College of Emergency Physicians (ACEP) began issuing position statements. 2 Richardson LD Asplin BR Lowe RA Emergency department crowding as a health policy issue: past developments, future directions. Ann Emerg Med. 2002; 40: 388-393 Abstract Full Text Full Text PDF PubMed Google Scholar In 2003 the General Accounting Office (GAO), commissioned by the U.S. Senate Committee on Finance, completed a national study of emergency departments. The study concluded that most hospitals experienced ED crowding to some degree, but the majority of crowding was confined to geographical areas with large populations, large recent population growth, and higher than average numbers of uninsured patients. 3 United States General Accounting Office Hospital emergency departments: crowded conditions vary among hospitals and communities (GAO publication No. 03-460). http://www.gao.gov/products/GAO-03-460 Google Scholar A follow-up report by the GAO in 2009 concluded that ED crowding continues to occur nationally and that wait times in the ED increased, in some cases exceeding the recommended time to see a provider based on acuity level. 4 United States General Accounting Office Hospital emergency departments: crowding continues to occur, and some patients wait longer than recommended time frames (GAO publication No. 09-347). http://www.gao.gov/products/GAO-09-347 Google Scholar These reports highlight the significance of ED crowding as a nationwide phenomenon affecting emergency departments across the United States, with the potential to negatively affect the quality of care that ED patients receive. Aaron A. Bellow Jr, Member, Golden Triangle Chapter, is Nurse Practitioner, The Schumacher Group, Christus Gulf Coast Facilities Emergency and Minor Care Departments, Beaumont, TX, and PhD Student, Duquesne University, Pittsburgh, PA. Gordon Lee Gillespie, Member, Greater Cincinnati Chapter, is Assistant Professor, University of Cincinnati College of Nursing, Cincinnati, OH. The Evolution of ED CrowdingJournal of Emergency NursingVol. 39Issue 5PreviewIn response to the article, “The Evolution of ED Crowding”1 it is refreshing to see attention given to the significance of this problem. I would like to share a tactic we have found useful at my facility. I am the director of emergency services at a moderate-volume, level III trauma center in a well-populated suburban area. The problem of ED overcrowding has been a struggle for my organization for a very long time. With The Joint Commission’s recent focus on the problem of ED overcrowding, I have witnessed a much-needed culture change at my facility. Full-Text PDF