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Emergency Department overcrowding and ambulance diversion: the impact and potential solutions of extended boarding of admitted patients in the Emergency Department.
J Emerg Med. 2006 Apr; 30(3):351-6.JE

Abstract

Emergency Department (ED) crowding and ambulance diversion have been increasingly significant national problems for more than a decade. Surveys of hospital directors have reported overcrowding in almost every state and 91% of hospital ED directors report overcrowding as a problem. The problem has developed because of multiple factors in the past 20 years, including a steady downsizing in hospital capacity, closures of a significant number of EDs, increased ED volume, growing numbers of uninsured, and deceased reimbursement for uncompensated care. Initial position statements from major organizations, including JCAHO and the General Accounting Office, suggested the problem of overcrowding was due to inappropriate use of emergency services by those with no urgent conditions, probably cyclical, and needed no specific policy response. More recently, the same and other organizations have more forcefully highlighted the problem of overcrowding and focused on the inability to transfer emergency patients to inpatient beds as the single most important factor contributing to ED overcrowding. This point has been further solidified by initial overcrowding research. This article will review how overcrowding occurred with a focus on the significance and potential remedies of extended boarding of admitted patients in the Emergency Department.

Authors+Show Affiliations

Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16677993

Citation

Olshaker, Jonathan S., and Niels K. Rathlev. "Emergency Department Overcrowding and Ambulance Diversion: the Impact and Potential Solutions of Extended Boarding of Admitted Patients in the Emergency Department." The Journal of Emergency Medicine, vol. 30, no. 3, 2006, pp. 351-6.
Olshaker JS, Rathlev NK. Emergency Department overcrowding and ambulance diversion: the impact and potential solutions of extended boarding of admitted patients in the Emergency Department. J Emerg Med. 2006;30(3):351-6.
Olshaker, J. S., & Rathlev, N. K. (2006). Emergency Department overcrowding and ambulance diversion: the impact and potential solutions of extended boarding of admitted patients in the Emergency Department. The Journal of Emergency Medicine, 30(3), 351-6.
Olshaker JS, Rathlev NK. Emergency Department Overcrowding and Ambulance Diversion: the Impact and Potential Solutions of Extended Boarding of Admitted Patients in the Emergency Department. J Emerg Med. 2006;30(3):351-6. PubMed PMID: 16677993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergency Department overcrowding and ambulance diversion: the impact and potential solutions of extended boarding of admitted patients in the Emergency Department. AU - Olshaker,Jonathan S, AU - Rathlev,Niels K, PY - 2004/04/26/received PY - 2005/02/09/revised PY - 2005/05/02/accepted PY - 2006/5/9/pubmed PY - 2006/10/13/medline PY - 2006/5/9/entrez SP - 351 EP - 6 JF - The Journal of emergency medicine JO - J Emerg Med VL - 30 IS - 3 N2 - Emergency Department (ED) crowding and ambulance diversion have been increasingly significant national problems for more than a decade. Surveys of hospital directors have reported overcrowding in almost every state and 91% of hospital ED directors report overcrowding as a problem. The problem has developed because of multiple factors in the past 20 years, including a steady downsizing in hospital capacity, closures of a significant number of EDs, increased ED volume, growing numbers of uninsured, and deceased reimbursement for uncompensated care. Initial position statements from major organizations, including JCAHO and the General Accounting Office, suggested the problem of overcrowding was due to inappropriate use of emergency services by those with no urgent conditions, probably cyclical, and needed no specific policy response. More recently, the same and other organizations have more forcefully highlighted the problem of overcrowding and focused on the inability to transfer emergency patients to inpatient beds as the single most important factor contributing to ED overcrowding. This point has been further solidified by initial overcrowding research. This article will review how overcrowding occurred with a focus on the significance and potential remedies of extended boarding of admitted patients in the Emergency Department. SN - 0736-4679 UR - https://www.unboundmedicine.com/medline/citation/16677993/Emergency_Department_overcrowding_and_ambulance_diversion:_the_impact_and_potential_solutions_of_extended_boarding_of_admitted_patients_in_the_Emergency_Department_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0736-4679(05)00442-7 DB - PRIME DP - Unbound Medicine ER -