Worldwide, ED Crowding is one of the most severe challenges that endanger the reliability of a healthcare facility. Crowding refers to a situation where the demand for emergency services surpasses the existing resources for executing emergency care in the department. Crowding in the Emergency department causes adverse challenges that influence patient flow in healthcare. Several strategies can be adopted to resolve the problems and improve the flow of patients.
Causes of ED Crowding
The primary cause of ED crowding is the shortage of resources. Often, the challenge arises when there is an imbalance between demand and supply. This implies that more patients are available to be served than the hospitals' resources. Among these include inadequate staffing. In the United States, the recommended ration of patients to nurses is 4:1. However, facilities tend to overload the practitioners to an extent they become overwhelmed by the work (Salway et al., 2017). Another cause of ED crowding is inadequate bed spaces. Usually, the admitted patients awaiting transfer from the emergency department cause a shortage in the number of beds. As a result, they find difficulties accepting more patients. Generally, ED crowding leads to poor performance and extended Length of Stay (LOS) for patients.
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Reducing Variability and Improving Patient Flow
There are three basic strategies used by facilities to diminish ED crowding together with the extended ED LOS. First is the reduction of demand by declining the number of ED cases. Griffin et al. (2016) assert that inefficiency can be reduced through the use of the full-capacity protocol to transfer ED patients to the inpatient lobbies in case of overcrowding.
The second approach is the increase in the facility's resources by hiring more staff and raising the weekly hours. This can increase the number of practitioners available to attend to patients. The final approach is matching demand and supply. The variation can be reduced through the increase of resource supply in case of crowding (Pines & Bernstein, 2015). For instance, a hospital may decide to increase the number of beds and staffs each time it experienced crowding to ensure efficiency.
Conclusion
Emergency Department is one of the critical units in a hospital. However, an increase in demand can cause a delay in service delivery, thus leading to crowding. Increase in supply resources like staff and beds can help to deal with the crowding issues and ensure quality and timely service delivery.
References
Griffin, P. M., Nembhard, H. B., DeFlitch, C. J., Bastian, N. D., Kang, H., & Muñoz, D. A. (2016). Healthcare systems engineering . John Wiley & Sons.
Pines, J. M., & Bernstein, S. L. (2015). Solving the global emergency department crowding problem–what can we learn from an Israeli ED? Israel Journal of health policy research , 4 (1), 52.
Salway, R. J., Valenzuela, R., Shoenberger, J. M., Mallon, W. K., & Viccellio, A. (2017). Emergency department (ED) overcrowding: evidence-based answers to frequently asked questions. Revista Médica Clínica Las Condes , 28 (2), 213-219.
