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Lack of inpatient beds is major cause of ED crowding

Hospitalist Leadership Connection, June 9, 2009

Crowding in the emergency department (ED) is caused, in part, because of a lack of inpatient beds, according to a recent report by Government Accountability Office, “Hospital Emergency Departments: Crowding Continues to Occur, and Some Patients Wait Longer than Recommended Time Frames,” published in April 2009.

In 2006, 119 million Americans visited the ED. Based on 2006 data, researchers studied indicators of ED crowding, including ambulance diversion, patient wait times, and patient boarding.

Researchers found that the majority of patients with an “immediate” acuity level, i.e., patients who should have be seen immediately (under one minute), waited about half an hour (28 minutes). Half of the patients with an “emergent” acuity level who had a recommended wait time of 1–14 minutes waited double that amount of time (37 minutes), according to the report.

However, urgent or semi-urgent patients were seen at an acceptable wait time. “Urgent” patients, who should be seen within 15–60 minutes, waited an average of 50 minutes—right on time. Those who were considered “semiurgent,” who should be seen within one to two hours, only waited 68 minutes.

“In terms of factors that contribute to crowding, we reported that crowding is a complex issue, and no single factor tends to explain why crowding occurs,” states the study. “However, we found that one key factor contributing to crowding was the availability of inpatient beds for patients admitted to the hospital from the emergency department.”

[via HospitalistLeadership.com]

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