Viewpoint: Why ED crowding is 'canary in the coal mine' for healthcare's dysfunction

Often dismissed as a minor inconvenience for patients, emergency department crowding is actually an important indicator of the U.S. healthcare system's functioning, eight emergency medicine physicians wrote in a commentary published Sept. 28 in NEJM Catalyst Innovations in Care Delivery.

ED crowding is a widespread problem in healthcare that increases the risk of patient harm and hinders staff morale, the authors said. This issue has only intensified during the pandemic.

Misaligned healthcare economics that pressure hospitals to keep a high inpatient census and give preferential queuing to high-margin patients is a major root cause of ED crowding, the authors said. They also cited primary care shortages, few after-hours outpatient care services and a lack of post-acute care facilities as other contributors.

"The key to a sustainable solution is to realign healthcare financing to allow hospitals to keep inpatient capacity below a critical threshold of 90 percent; beyond that, hospital throughput dynamics will inevitably lead to ED crowding," they argued. 

The authors said healthcare leaders have a moral imperative to address these capacity issues and alleviate patient safety risks in the ED. 

"Like the ailing canary in the coal mine, ED crowding is a symptom of healthcare system dysfunction. The canary's condition is critical," they concluded. "Without action, patients will continue to be at a heightened risk of harm. Time for real action is now."

To view the full article, click here.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars