Tags

Type your tag names separated by a space and hit enter

ED crowding is associated with variable perceptions of care compromise.
Acad Emerg Med. 2007 Dec; 14(12):1176-81.AE

Abstract

OBJECTIVES

The authors measured the association between emergency department (ED) crowding and patient and provider perceptions about whether patient care was compromised.

METHODS

This was a cross-sectional study of patients admitted from the ED and their providers. Surveys of patients, nurses, and resident physicians were linked. The primary outcome was agreement or strong agreement on a five-item scale assessing whether ED crowding compromised care. Logistic regression was used to determine the association between the primary outcome and measures of ED crowding.

RESULTS

Of 741 patients approached, 644 patients consented (87%); 703 resident physician surveys (95%) and 716 nursing surveys (97%) were completed. A total of 106 patients (16%), 86 residents (12%), and 173 nurses (24%) reported that care was compromised by ED crowding. In 252 cases (35%), one or more respondents reported that care was compromised. There was poor agreement over whose care was compromised. For patients, independent predictors of compromised care were waiting room time (odds ratio [OR], 1.05 for each additional 10-minute wait [95% confidence interval {CI} = 1.02 to 1.09]) and being surveyed in a hallway bed (OR, 2.02 [95% CI = 1.12 to 3.68]). Predictors of compromised care for nurses included waiting room time (OR, 1.05 for each additional 10-minute wait [95% CI = 1.01 to 1.08]), number of patients in the waiting room (OR, 1.05 for each additional patient waiting [95% CI = 1.02 to 1.07]), and number of admitted patients waiting for an inpatient bed (OR, 1.08 for each additional patient [95% CI = 1.03 to 1.12]). For residents, predictors of compromised care were patient/nurse ratio (OR, 1.39 for a one-unit increase [95% CI = 1.09 to 1.20]) and number of admitted patients waiting for an inpatient bed (OR, 1.14 for each additional patient [95% CI = 1.10 to 1.75]).

CONCLUSIONS

ED crowding is associated with perceptions of compromised emergency care. There is considerable variability among nurses, patients, and resident physicians over which factors are associated with compromised care, whose care was compromised, and how care was compromised.

Authors+Show Affiliations

Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. pinesjes@uphs.upenn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18045894

Citation

Pines, Jesse M., et al. "ED Crowding Is Associated With Variable Perceptions of Care Compromise." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 14, no. 12, 2007, pp. 1176-81.
Pines JM, Garson C, Baxt WG, et al. ED crowding is associated with variable perceptions of care compromise. Acad Emerg Med. 2007;14(12):1176-81.
Pines, J. M., Garson, C., Baxt, W. G., Rhodes, K. V., Shofer, F. S., & Hollander, J. E. (2007). ED crowding is associated with variable perceptions of care compromise. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 14(12), 1176-81.
Pines JM, et al. ED Crowding Is Associated With Variable Perceptions of Care Compromise. Acad Emerg Med. 2007;14(12):1176-81. PubMed PMID: 18045894.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - ED crowding is associated with variable perceptions of care compromise. AU - Pines,Jesse M, AU - Garson,Chad, AU - Baxt,William G, AU - Rhodes,Karin V, AU - Shofer,Frances S, AU - Hollander,Judd E, PY - 2007/11/30/pubmed PY - 2007/12/21/medline PY - 2007/11/30/entrez SP - 1176 EP - 81 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 14 IS - 12 N2 - OBJECTIVES: The authors measured the association between emergency department (ED) crowding and patient and provider perceptions about whether patient care was compromised. METHODS: This was a cross-sectional study of patients admitted from the ED and their providers. Surveys of patients, nurses, and resident physicians were linked. The primary outcome was agreement or strong agreement on a five-item scale assessing whether ED crowding compromised care. Logistic regression was used to determine the association between the primary outcome and measures of ED crowding. RESULTS: Of 741 patients approached, 644 patients consented (87%); 703 resident physician surveys (95%) and 716 nursing surveys (97%) were completed. A total of 106 patients (16%), 86 residents (12%), and 173 nurses (24%) reported that care was compromised by ED crowding. In 252 cases (35%), one or more respondents reported that care was compromised. There was poor agreement over whose care was compromised. For patients, independent predictors of compromised care were waiting room time (odds ratio [OR], 1.05 for each additional 10-minute wait [95% confidence interval {CI} = 1.02 to 1.09]) and being surveyed in a hallway bed (OR, 2.02 [95% CI = 1.12 to 3.68]). Predictors of compromised care for nurses included waiting room time (OR, 1.05 for each additional 10-minute wait [95% CI = 1.01 to 1.08]), number of patients in the waiting room (OR, 1.05 for each additional patient waiting [95% CI = 1.02 to 1.07]), and number of admitted patients waiting for an inpatient bed (OR, 1.08 for each additional patient [95% CI = 1.03 to 1.12]). For residents, predictors of compromised care were patient/nurse ratio (OR, 1.39 for a one-unit increase [95% CI = 1.09 to 1.20]) and number of admitted patients waiting for an inpatient bed (OR, 1.14 for each additional patient [95% CI = 1.10 to 1.75]). CONCLUSIONS: ED crowding is associated with perceptions of compromised emergency care. There is considerable variability among nurses, patients, and resident physicians over which factors are associated with compromised care, whose care was compromised, and how care was compromised. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/18045894/ED_crowding_is_associated_with_variable_perceptions_of_care_compromise_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1069-6563&date=2007&volume=14&issue=12&spage=1176 DB - PRIME DP - Unbound Medicine ER -