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Emergency Department Crowding: A Call for Unity

Flores CR

Emergency Department. Lawrence Hospital Center. Bronxville. Nueva York, USA.

ED crowding is a global issue. It impact on millions of patient every day. Crowding must
be seen as patient safety and quality issue and not just as an operational issue. The
evidence suggests that, while there are many factors contributing to ED crowding,
emergency physicians must adopt a definition that centers on quality. The definition
must include the dimensions adopted by the Institute of Medicine and follow the
guidelines discussed above. Likewise emergency physicians must argue that ED
crowding must rise to the same level of importance as eliminating wrong site surgery,
decreasing hospital acquired infections and the other goals listed in table 1. Emergency
physicians must argue that national and regulatory standards addressing patient be
implemented and adhered to by hospitals. The time has come to accept that the factors
associated with crowding are not within the control of emergency physicians during
their day to day activities. While adding resources to our emergency departments may
be helpful, asking or demanding increased productivity form EPs and ED staff will not
correct this problem. While multi-factorial the reason for ED crowding are not found in
the influx of patients or the internal processes of the ED. The reasons are in the output;
they are found within the processes of the organizations emergency departments
support. Staffing critical care beds, allocating general acute care beds for ED patients
and transporting these patients to those beds are the essential components to solving
this global crisis. ED crowding has been present for over twenty years. The time has
come for a unity of purpose, definition, research, solution and adherence following
established guidelines for the delivery of quality care.

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