Overcrowding is an unavoidable and common phenomenon affecting hospital emergency departments (EDs). It has negative effects on patient safety, care delivery, nurse satisfaction, and organizational management. It is therefore essential to identify the primary causes of overcrowding.
EDs are not only overwhelmed by patients with varying needs, but also by an insufficient number of beds available to accommodate them. The result is that patients are stuck in the ED and are not able to be transferred out of the hospital. This leads to poor flow of patients throughout the hospital and, ultimately, to high mortality rates.
A recent study published in Health Services Research reported that people were 5.4% more likely to die on days when their hospital’s ED was crowded compared with other days. This finding suggests that the primary reason for this increase in death risk is due to a mismatch between the availability of beds and demand.
The authors would like to thank all the nursing administrators and ED nurses in the five hospitals that participated in this study for their valuable inputs. In addition, the authors acknowledge the support of King Khalid University College of Nursing – Abha and the Deanship of Scientific Research for funding this work under general project grant RGP.2/169/44.
The development of the questionnaires started with a scoping review of published articles and a systematic evaluation of preexisting-validated questionnaires on ED overcrowding and its consequences. Next, a series of elicitation interviews with expert clinicians were conducted to identify and evaluate clinical aspects that could influence overcrowding and the outcomes of its management.