Key Resources

"The Future of Emergency Care in United States Health System" by the Institute of Medicine
(2006) Institute of Medicine
Emergency department crowding is due to a variety of reasons including an increase in the uninsured and the lack of access to primary healthcare in rural settings. This overcrowding leads to increased boarding of patients in the emergency room and also an increase in ambulance diversion. The Institute of Medicine has recommended a multi-pronged strategy which includes improving hospital efficiency and patient flow; having in place a coordinated, regionalized, accountable system; increasing resources; and paying attention to children.

"Emergency Nurses Association Position Statement: Crowding in the Emergency Department"
(2006) Journal of Emergency Nursing
The ENA listed many causes of EDC which include: increase in hospital closures; high patient acuity; increase of patient flow into the ER due to EMTALA, yet legislation is not adequately funding hospitals and emergency departments in their efforts to carry out this mandate; issues of reduced resources; and lack of staffed inpatient treatment beds.

Urgent Matters
Urgent Matters, a national initiative funded by the Robert Wood Johnson Foundation, is dedicated to finding, developing and delivering strategies to improve patient flow and reduce emergency department (ED) crowding.
http://www.urgentmatters.org/aboutProject/overview.asp

Other Related ENA Positions:

Access to Health Care (2/2006) http://www.ena.org/about/position/PDFs/6CE461368BEA4572B6530BA0E0E0A401.pdf

Customer Service and Satisfaction in the Emergency Department (2/2003) http://www.ena.org/about/position/PDFs/CustomerService.PDF

Holding Patients in the Emergency Department (5/2006) http://www.ena.org/about/position/PDFs/CustomerService.PDF