Overcrowding of hospital emergency departments (EDs) has become a global challenge. Many patients are experiencing prolonged wait times to be treated due to limited bed capacity and inefficient patient flow. This results in poor patient satisfaction and a decrease in trust in the healthcare system.
The cause of ED overcrowding is multifactorial, but most frequently triggered by inefficient patient flow and the lack of a sufficient number of hospital beds. According to an online survey, the most commonly perceived causes of ED overcrowding include unnecessary visits (M = 2.71; SD 0.58), lack of ED inpatient beds (M = 2.65; SD 0.65), and prolonged length of stay in the ED due to delay in transfer to a hospital bed or home care services (M = 2.62; SD 0.55).
A large part of the solution lies with effective management strategies. These may include bedside registration, use of hospitalists in triage, and optimization of provider schedules. In addition, smoothing of elective admissions and early morning discharges of inpatients significantly decreases ED boarding and improves access to inpatient beds.
However, these strategies are not without limits. The problem is exacerbated by factors outside of the control of EDs, such as insufficient primary and mental health care and delays in transferring patients to hospital inpatient beds. To solve the problem, hospital management and healthcare stakeholders need to work together to develop comprehensive strategies to improve patient flow and upstream interventions that curb avoidable ED visits.