Abstract:
Emergency departments are experiencing overcrowding on an every day basis and
there are growing concerns about their ability to provide safe and timely care. The
increase in patient volume and acuity, coupled with insufficient treatment rooms
has regularly resulted in patients being nursed in corridors. This situation is made
infinitely worse by the lack of inpatient hospital beds. Those waiting consistently
endure long and uncomfortable delays for treatment in busy, noisy emergency
environments. Overcrowding within emergency departments leads at best to
patient dissatisfaction and at worst to poor clinical outcomes.
Overcrowding also has adverse effects on health professionals working in
emergency care. There is evidence of stress, "burnout" and a high turnover of staff
in this area. The daily struggle to provide care to the acutely unwell along with
patients awaiting ward beds, results in frustration and anxiety. Nurses are
concerned about the safety of patients in an overcrowded department. They are
frustrated by their inability to provide the care patients deserve and they are
demoralised because they cannot fulfil the role for which they trained.
This study looks at the many and varied causes of emergency department
overcrowding and examines the effects of this phenomenon on patients and staff.
Literature from New Zealand and international emergency care journals is
explored to identify the many issues relevant to the overcrowding crisis.
Overcrowding is currently the most pressing issue facing emergency departments.
It was first described over 20 years ago and solutions are still being sought. There
is increasing recognition that emergency department overcrowding is a symptom
of system-wide problems within hospitals. Emergency health professionals have
highlighted their concerns about overcrowded emergency departments. It is time
now for governments, policy makers, and hospital management to respond to this
crisis to ensure a better future for emergency care.
