Emergency Department Overcrowding, Examining the Causes and Effects

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.